Analysis of the reasons for the retention of long time testicular torsion and surgical selection of contralateral testis in children / 中华实用儿科临床杂志

ABSTRACT

Objective:To explore the reasons for the retention of long time testicular torsion and the surgical selections of contralateral testis in children.Methods:The data of children with acute scrotal emergencies treated by the First Affiliated Hospital of Zhengzhou University from August 2016 to August 2019 were retrospectively analyzed.All the testicular torsion was included in the study sequence to summarize the clinical characteristics of the testicle that could be saved and different treatment methods adopted in the contrary side according to the anatomy of testes.Results:A total of 80 children with testicular torsion were included in the study.The onset time ranged from 2 hours to 15 days.All patients came to the hospital with unilateral scrotal pain or inguinal pain, including 74 cases of unilateral testicular torsion and 6 cases of cryptorchidical testicular torsion.All the children were treated with surgery.Orchiectomy was performed in 69 cases of testicular necrosis, and 11 cases were saved, among which 4 cases took a long time for testicular torsion, the main reason for the retention was the longer spermatic cord in the tunica vaginalis.Of the 80 healthy testes, the adhesion of the testis to tunica vaginalis was normal in 63 cases and abnormal in 17 cases.There were 20 children (including 5 children with abnormal anatomy) were routinely treated with partial removal of the tunica vaginalis and orchiopexy.Among the remaining 60 cases, 12 cases with abnormal adhesion of the testis to tunica vaginalis underwent partial removal of the tunica vaginalis and orchiopexy, and the other 48 cases with normal anatomy received the testis examination and the original incision closure.During the follow-up of 80 cases, 5 cases of the 11 children with the testis preserved returned to normal, 6 cases of them showed atrophy to varying degrees, and no discomfort such as torsion or pain was found in all the healthy testes.Conclusions:The long spermatic cord in the tunica vaginalis is the reason for long time testicular torsion in children with the testis saved.It buys time for the rescue of their testes.Orchiopexy is not necessary for those who have normal anatomy of the healthy testes, while partial removal of the tunica vaginalis and orchiopexy are recommended for patients with bell clapper anomaly.