[Clinical studies on acute scrotum--focusing on torsion of the spermatic cord].

Surgical exploration was done on 50 patients with acute scrotum between June 1982 and October 1995. Of them, 24 (48%) had torsion of the spermatic cord, 9 (18%) had torsion of the appendage testis, 11 (22%) had intrascrotal hematoma, 4 (8%) had acute epididymitis, and 2 (4%) had bleeding of testicular tumor. The patients who had torsion of the spermatic cord were between 0 and 26 years of age (the mean: 14.6); 9 had torsion on the right side, and 15 on the left side. Infectious manifestations occurred in about 30%, and Prehn's sign developed in 37.5%. Of all cases, orchiopexy was performed in 10 cases and orchiectomy in 14. The testis was saved in 8 (88.9%) of the 9 patients who underwent surgery within 12 hours after onset. On the contrary, the testis was saved in only 2 (13.3%) of the 15 patients who underwent surgery more than 12 hours after onset. We concluded that early consultation, and exploration by a urologist are obligatory in the treatment of torsion of the spermatic cord.