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TheScientificWorldJOURNAL
Volume 11 (2011), Pages 362-368
http://dx.doi.org/10.1100/tsw.2011.39
Research Article

Testicular Torsion in Children: A 20-Year Retrospective Study in a Single Institution

1Department of Pediatric Surgical Oncology, Children's Hospital of Chongqing Medical University, Chongqing, China
2The Department of Laboratory Examination, Affiliated Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wu Han City, China
3Department of Pediatric Urology, Children's Hospital of Chongqing Medical University, Chongqing, China

Received 11 September 2010; Revised 9 January 2011; Accepted 14 January 2011

Academic Editor: Anthony Atala

Copyright © 2011 Chao Yang et al.

Abstract

In this paper, we evaluated the historical features and physical examination findings, as well as laboratory tests and ultrasound examinations, in children with testicular torsion (TT), in order to improve diagnosis and treatment in this population. A retrospective review of patients with diagnosis of TT between January 1990 and January 2010 was performed. We included 118 cases in the study, accounting for 9.01% of all cases of acute scrotum. Mean patient age was 9.3 ± 5.6 years. The left side was predominantly affected. The median duration of symptoms up to surgical exploration was 64 h. Absence of cremasteric reflex presented in 94.9% patients. All boys had an ultrasound of the scrotum; decreased or absent blood flow was observed in all orchidectomy patients. Heterogeneous echogenicity presented in all cases of orchidectomy. At surgery, viable testes were present in 46 boys (39%) and preserved; in 72 boys with nonviable testes, they were removed. The median duration of symptoms at presentation was 12 h when the testes were successfully conserved and 90 h when they were removed. Testicular salvage depends critically on early surgical intervention. Ultrasound is a useful tool for the clinical assessment of patients with TT, however, sonographic interpretation must be in conjunction with the clinical manifestations. We advocate immediate surgical exploration with suspected TT. Long-term hormonal levels are within the normal range regardless of the fate of the testis. Further follow-up is needed to confirm fertility after TT.