Intrascrotal anomalies related to testicular torsion in nigerians: an anatomical study

ABSTRACT

Objective: The abnormalities that predispose to torsion are often bilateral. They include horizontally lying testis; bell-clapper deformity (BCD); long mesorchium; well-developed spiral cremasteric muscle and ectopic testis. The pattern and incidence of intrascrotal anomalies that predispose to testicular anomalies in Nigerians have not been studied. Our objective was to define and document this. Material and Methods: The scrotal sacs of fifty cadaver scrotums and inguinal canals from patients aged between 35 and 57 years (mean age 42 years) were examined. The parameters studied were the location (scrotal or canalicular); alignment (horizontal; vertical); mesorchium (height and width); cremasteric muscle development (well or poorly developed) and parietal tunica vaginalis investment of the testis (normal; intermediate or BCD). Results: Forty-nine testes had descended to the scrotal position; all were anchored by the ligamentum testis. The canalicular position was noted to be present in one cadaver. Forty-eight testes lay vertically. 16of the testes had BCD; while intermediate tunica investment was noted in 12. The most common type of epididymal and testicular relationship was Type I (84). The mesorchium was normal in all specimens examined. Conclusion: The most common anomaly in our study was that of tunica investment; and this is usually bilateral. The need for bilateral orchiopexy in cases of testicular torsion is further strengthened since the anatomic anomalies are usually bilateral