Testicular torsion: a 15‐year single‐centre clinical and histological analysis
Authors: Saxena, AK; Castellani, C; Ruttenstock, EM; Höllwarth, ME
Source: Acta Pædiatrica, Volume 101, Number 7, 1 July 2012 , pp. e282-e286(5)
Aim: This study reviewed the demographic, epidemiological and clinical factors of boys seen at a single centre who underwent surgical exploration for testicular torsion.
Methods: Retrospective single‐centre review of boys with testicular torsion between 1996 and 2011 was made.
Results: Testicular torsion (right n = 43, left n = 60, bilateral n = 1) was identified in 104 boys between 0 and 18 years. Ten newborns presented with 11 intrauterine torsions. Nine torsions presented in undescended inguinal testes (one intrauterine). In 94 boys with descended testes, presentation included pain (76%), scrotal swelling (65%) and abdominal symptoms (22%). Ultrasonography was performed in 85 patients with false‐negative results in 4 (4.7%). Orchiectomy was performed during initial exploration in 41, with significantly higher rates of orchiectomies in patients with late (>6 h) versus patients with early referrals (<6 h) (56% vs. 9.1%). Histological evaluation was carried out in 68 testes, with 43 resected testes demonstrating haemorrhagic necrosis. In 25 biopsied testes, histology revealed acute parenchymal bleeding (n = 14), onset of parenchymal infarction (n = 8), orchitis (n = 1) and normal tissue (n = 2). Eighty‐two patients were followed up with pathological findings in four patients: testicular atrophies requiring orchiectomy (n = 2), testicular autolysis (n = 1) and small testicular vein thrombosis (n = 1).
Conclusion: Chances of testicular salvage after torsion are higher if patients present early. The majority of patients presenting late (>6 h) require orchiectomy owing to testicular necrosis.
Document Type: Research Article
Affiliations: Department of Pediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
Publication date: July 1, 2012