Treatment of testicular torsion in children: One surgeon experience

Abstract

Aim Testicular torsion (TT) is an urgency that requires operation in children. Here, it was aimed to investigate the characteristics of cases operated on due to TT and to discuss its results in light of the literature. Material and Methods:Operated due to TT, 22 cases and their ages, time spent between initial of complaints and hospital admission, color-Doppler-ultrasonography (CDUS) findings, degree of torsion and the results were investigated retrospectively. Results: While median (IQR) age was 7.5 (12.25) years (4hours-16years), median (IQR) application time was 18.5 (33) hours. Three cases were with prenatal torsion. The most common complaints were pain, swelling, discoloration of scrotum, and vomiting. Three cases were admitted with inguinal masses, two of whom were undescended TT. Left testicles were torsioned in 17 cases. Median (IQR) TT degree was 540 (225). While CDUS was descriptive in 20 patients, it was reported as epididymo-orchitis and hydrocele in two cases. Orchiectomy was performedin eight cases, while testicular detorsio-fixation was performed in 14 cases. The cases undergoing orchiectomy had an average of 792 degree. Two of these were prenatal, and two were undescended TT. Mean application time for the other four cases was 83.5 hours. Conclusion: For early and true diagnosis of TT, CDUS is a quite effective method. If reported not to be perfusion, the case is certainly assessed as torsion. If reported as epididymo-orchitis or hydrocele in CDUS, but suspected to be torsion, the patient should be explored immediately.