Torsion of the testis: a review of 14 cases

To evaluate our experience in dealing with testicular torsion in neonates and children. this is a retrospective review of 14 medical records for children admitted for surgical treatment of testicular torsion during the period between 1996-2002 at King Hussein Medical Center. Clinical symptoms, time of presentation, age, diagnostic methods, intervention and outcome were recorded. Two neonates and 12 children underwent surgical exploration for testicular torsion. Eight patients presented with sudden onset of unilateral testicular pain, swelling, and tenderness. Six patients came with absence of one or more of these symptoms. Ten patients presented after 14 hours of onset of symptoms. Doppler U/S failed to prove the diagnosis in 4 out of 5 cases. Two cases were diagnosed initially as incarcerated inguinal hernia and one case as acute hydrocele. All underwent surgical exploration. Salvage of testis was successful in only 6 patients [43%]. The other 8 patients, two of them were neonates had necrotic testes. All patients who presented at 12 hours or less from onset of symptoms were successfully treated. early time of presentation of children with testicular torsion less than 12 hours, and immediate exploration based on clinical suspicion are the key for testicular salvage. Neither age nor U.S doppler should override decision to operate in case of suspicion