A clinical observation on torsion of the testis / 대한비뇨기과학회지

ABSTRACT

A clinical observation was made on 20 patients with testicular torsion admitted at Seoul Red Cross hospital between May l988 and F8bruary 1991 to find out reliable digcriminations on the differential diagnosis and useful informations about the treatment. Clinical features. operative findings and laboratory data were reviewed through the medical records. Of the patients 15(75%) were in age of second decade and 5 (25%) were in age of third decade. Torsion occurred during the cold weather in 14 cases(70% ). The onset of testicular pain was sudden in 14 cases(70%) and previous episodes of testicular pain were present in 10 cases(50%). Torsion occurred on the left side in 17 cases(85%). On physical examination. 13 patients(65%) showed horizontal lie of affected testis. Urinalysis was negative in 18 cases(90%). According to the interval time between the onset of testicular pain and of detorsion, testicular salvage rate was 100% within 6 hours, 89% within 12 hours but 9% in case of over 12 hours. According to the degree of torsion, testicular salvage rate was 50% in case of below 360` and 33% in cases of over 360`. In all 20 cases of testicular torsion, a type of anatomical anomaly was round in torsed testis. that was bell-clapper deformity in 18 cases(90%), long mesorchium in one and ectopic testis in one case. In the contralateral testis, bell-clapper deformity was round in 13 cases(65%). We found the following informations about the testicular torsion. I. It second. there are some reliable features in differential diagnosis, those are age of patients in his second decade. onset in cold weather. more sudden onset of pain, presence of previous episodes, occurrence on the left side, horizontal lie of affected testis and negative urinalysis. 2. Testicular salvage rate after testicular torsion seemed to relate more closely with time between the onset of symptoms and detorsion rather than the degree of torsion. It is advisable to detorse testis at least within 12 hours after the onset of symptoms for testicular salvage. 3. Bell-clapper deformity was found in majority of cases in torsed testis and 65% in the contralateral testis. Therefore. it is reasonable to explore contralateral testis and fix it if needed.