[Clinical examination of torsion of the spermatic cord--review of 177 cases reported in the recent Japanese literature including our present 7 cases].

Between January 1974 and December 1984, 16 patients underwent surgical exploration at our Hospital. Seven of these patients proved to have torsion of the spermatic cord and nine were strongly suspected to have this lesion in spite of lack of torsion during operation and the remaining 3 patients suffered from epididymitis. The 7 patients with torsion ranged in age from 14 to 22 years old. The left side was involved in 4 patients, and the right side in 3 patients. Six patients had internal rotation and 1 had external rotation. In all of them, intravaginal torsion was noticed at various degrees of twist (270 degrees-540 degrees). Orchidopexy was performed in 5 cases in which the operation could be done within 15 hours after onset of the symptom but in 2 cases in which 50, and 56 hours had elapsed orchidectomy was unavoidable. The 177 cases reported in the Japanese literature since Kumon's report including our present 7 cases were reviewed statistically in detail. Case reports of this lesion, especially in newborns, is increasing every year. The age distribution showed two peaks, one at the time of puberty (10-19 years old) and the other shortly after birth. There was a predominance for the left side, internal rotation and twisted degrees of 180 degrees to 360 degrees in this series. In the cases in which over 24 hours has elapsed before surgery, orchidectomy was performed frequently.