Another look at torsion of testis

Williams, James D.; Hodgson, Norman B.

doi:10.1016/0090-4295(79)90209-7

Cited by 18 publications

(4 citation statements)

References 17 publications

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“…Limited knowledge of this fact may partially explain the 10% salvage rate often seen until 40 years ago (17), and, thankfully, there has been a trend towards better salvage rates in the last decades. Williams (18), in 1979, salvaged 69% of his cases, and Jones (7), in 1986, 75%. The best salvage rate so far recorded, 97.6%, comes from Ireland (19), even though at a cost of a 52.9% false-positive rate.…”

Section: Discussionmentioning

confidence: 99%

The amount of spermatic cord rotation magnifies the time-related orchidectomy risk in Intravaginal testicular torsion

Filho¹,

Alves²,

Filho³

et al. 2016

Int. braz j urol.

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PurposeTo investigate the roles of age, testicular rotation and time in the surgical outcome of intravaginal testicular torsion (iTT).Patients and MethodsWe retrieved the records of all iTT patients treated in our unit from January 2012 to January 2014. Explanatory variables were: age (years); presentation delay (PrD, time between symptoms and hospitalization); surgical delay (SurgD, time between hospitalization and surgery) and testicular rotation (rotation), with surgical outcome (orchidopexy, orchidectomy) as response variable. Differences in PrD, SurgD, age and rotation by surgical outcome were evaluated non-parametrically. Step-down logistic regression included age, PrD, SurgD and rotation as predictors. Statistical significance and confidence intervals (CI) were set at p<0.05 and 0.95. Odds ratios (OR) were computed from the model's coefficients.ResultsComplete variable information was available for 117 patients, and most (61, 52.1%) underwent orchidectomy. Ages were similar between orchidectomy and orchidopexy patients (median 15.8 vs. 16.0 years, p=0.78). In contrast, PrD (85.0 vs. 8.4 hours, p<0.001), SurgD (3.0 vs. 16.0 hours, p<0.001) were different between orchidectomy and orchidopexy patients. SurgD was similar with PrD<24 hours (4.0 vs. 2.8, p=0.1). Orchidectomy patients had greater rotation (3.0π vs. 2.0π radians, p<0.001). Logistic regression revealed that PrD (OR 0.94; 0.92–0.97; p<0.001) and rotation (OR 0.43; 0.27–0.70; p<0.001) were inversely associated with orchidopexy.ConclusionTesticular rotation exerts a multiplicative effect on PrD, so time should not be regarded as the sole predictor of surgical outcome in iTT.

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Section: Discussionmentioning

confidence: 99%

The amount of spermatic cord rotation magnifies the time-related orchidectomy risk in Intravaginal testicular torsion

Filho¹,

Alves²,

Filho³

et al. 2016

Int. braz j urol.

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“…Several retrospective studies have reported the outcome of the twisted testis on the basis of immediate salvage rates (Williams and Hodgson, 1979;Cattolica et al, 1982;Goulbourne et al, 1984), yet the frequency of late atrophy renders these figures unreliable (Thomas and Williamson, 1983). Others have examined the functional outcome in terms of spermatogenesis and hormonal secretion.…”

mentioning

confidence: 99%

The Fate of the Human Testes Following Unilateral Torsion of the Spermatic Cord

Anderson¹,

Williamson²

1986

British Journal of Urology

133

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In an attempt to explain the oligozoospermia commonly observed after unilateral testicular torsion, 56 patients with acute torsion were investigated prospectively. Blood was taken pre-operatively for antibody studies and a contralateral testicular biopsy was performed at the time of orchiopexy. At review 3 to 6 months post-operatively, late testicular atrophy was assessed and repeat antibody studies were performed together with a hormone profile and seminal analysis. Although the duration of torsion showed a close correlation with the degree of testicular atrophy (P less than 0.001), no such association could be demonstrated between duration of torsion and subsequent sperm concentration. Twenty of 35 patients had histological evidence of a pre-existing partial maturation arrest in spermatogenesis. Fifteen of 19 with the abnormality were oligozoospermic, while all of those with normal testicular histology had a sperm concentration within the normal range. Anti-sperm antibody formation following torsion was minimal and antitestis antibodies were absent. Testes prone to torsion already show impaired spermatogenesis.

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“…There have been clinical reports that unilateral testicular torsion induces disorders not only in the affected testis, but also in the opposite testis, resulting in decreased fertility. 2,3 Bartsch et al 4 found inferior semen properties in 15 of 30 cases and noted that the cause was immune response induced by changes in endocrine environment, such as increases in folliclestimulating hormone (FSH) and luteinizing hormone (LH). Thomas and Williamson 5 observed very severely affected semen properties in 12 and slightly affected semen properties in five of 21 cases of this disease, and the properties were normal in only three cases.…”

Section: Discussionmentioning

confidence: 99%