Zhonghua nan ke xue = National journal of andrology · 2019
[Clinical characterization of incomplete testicular torsion in children].
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Guo Xiang, Li Shuang, Chen Hai-Tao, Guo Hui, Lei Wei
Аннотация
OBJECTIVE: To analyze the clinical characteristics of incomplete testicular torsion (ITT) in children in order to gain a deeper insight into the disease.
METHODS: This retrospective study included 37 children with ITT treated in our hospital from April 2007 to April 2017. We analyzed the clinical characteristics and results of physical examination, laboratory examination, ultrasonography and treatment.
RESULTS: The patients were aged 1－14 (mean 5.7) years, with a high incidence of ITT at 2－4 and 12－14 years and a disease course of 12－96 (48 ± 8) hours. Preoperative color Doppler ultrasonography showed reduced blood flow signals in the affected testis in 31 cases (83.8%) and transverse testis with normal blood flow signals in the other 6 (16.2%). Anticlockwise torsion was found in 27 cases (72.9%), clockwise torsion in 10 (27.1%), 90-degree torsion in 7 (18.9%), 180-degree torsion in 20 (54.0%), 270-degree torsion in 10 (27.1%), intravaginal torsion in 31 (83.8%) and extravaginal torsion in 6 (16.2%). According to Arda's three grades of testicular tissue bleeding, 16 cases (43.3%) were categorized as grade Ⅰ and 21 (56.7%) as grade Ⅱ, and so the affected testes were preserved in all the cases during the operation. The patients were followed up for 12 months postoperatively, which revealed testicular atrophy in 6 cases (16.2%).
CONCLUSIONS: ITT occurs in children at a young age, of less than 360 degrees in all cases, mostly 180 degrees, and the survival rate of the affected testis is high after surgery. Reduction in testicular blood flow signals at preoperative color Doppler examination is an important indication in the diagnosis of the disease.
METHODS: This retrospective study included 37 children with ITT treated in our hospital from April 2007 to April 2017. We analyzed the clinical characteristics and results of physical examination, laboratory examination, ultrasonography and treatment.
RESULTS: The patients were aged 1－14 (mean 5.7) years, with a high incidence of ITT at 2－4 and 12－14 years and a disease course of 12－96 (48 ± 8) hours. Preoperative color Doppler ultrasonography showed reduced blood flow signals in the affected testis in 31 cases (83.8%) and transverse testis with normal blood flow signals in the other 6 (16.2%). Anticlockwise torsion was found in 27 cases (72.9%), clockwise torsion in 10 (27.1%), 90-degree torsion in 7 (18.9%), 180-degree torsion in 20 (54.0%), 270-degree torsion in 10 (27.1%), intravaginal torsion in 31 (83.8%) and extravaginal torsion in 6 (16.2%). According to Arda's three grades of testicular tissue bleeding, 16 cases (43.3%) were categorized as grade Ⅰ and 21 (56.7%) as grade Ⅱ, and so the affected testes were preserved in all the cases during the operation. The patients were followed up for 12 months postoperatively, which revealed testicular atrophy in 6 cases (16.2%).
CONCLUSIONS: ITT occurs in children at a young age, of less than 360 degrees in all cases, mostly 180 degrees, and the survival rate of the affected testis is high after surgery. Reduction in testicular blood flow signals at preoperative color Doppler examination is an important indication in the diagnosis of the disease.