Smith S P, King L R
Urol Clin North Am. 1979 Jun;6(2):429-43.
Results of treatment of torsion of the testicle can be measured only by determining the rate of testicular salvage, which has been low but has improved in recent years. The Doppler instruments and the technique of scrotal imaging with the gamma camera provide noninvasive and rapid diagnostic aids with a high degree of accuracy. There is evidence that these techniques will aid in the differential diagnosis of equivocal cases, and thus lower the incidence of delay in the diagnosis of torsion, a cause of lower than optimal salvage rates in the past. Fluorescein staining can also be used in the operating room if there is a question of testicular viability. The availability of these new modalities, however, is no substitute for early evaluation. Quick referral from primary physicians and a high awareness of torsion as a cause of acute scrotal pain and swelling are extremely important. Reviews clearly indicate that improved salvage rates are achieved with early evaluation and treatment. Therefore the urologist has a continuing responsibility to educate pediatricians, family practitioners, and emergency room physicians in the urgency of diagnosis and treatment in cases of testicular torsion. Although new diagnostic aids are useful, only early surgical exploration can save a torsive testis.
睾丸扭转的治疗结果只能通过确定睾丸挽救率来衡量，该比率一直较低，但近年来有所提高。多普勒仪器和用γ相机进行阴囊成像的技术提供了无创且快速的诊断辅助手段，具有高度的准确性。有证据表明，这些技术将有助于模棱两可病例的鉴别诊断，从而降低扭转诊断延迟的发生率，扭转诊断延迟是过去挽救率低于最佳水平的一个原因。如果存在睾丸存活能力的问题，荧光素染色也可在手术室中使用。然而，这些新方法的可用性并不能替代早期评估。初级医生的快速转诊以及对扭转作为急性阴囊疼痛和肿胀原因的高度认识极其重要。综述明确表明，早期评估和治疗可提高挽救率。因此，泌尿科医生有持续的责任向儿科医生、家庭医生和急诊室医生传授睾丸扭转病例诊断和治疗的紧迫性。尽管新的诊断辅助手段很有用，但只有早期手术探查才能挽救扭转的睾丸。
