Long-term follow-up results of testicular torsion in children

Abstract

A retrospective cohort study was conducted at the Children’s Hospital of Chongqing Medical University from November 2004 to December 2020 to investigate the long-term follow-up results after testicular torsion (TT) in children. Boys with TT were divided into the salvage orchiopexy group and the orchiectomy group, and the baseline characteristics, ultrasonographic indications, intraoperative findings, testicular volumes, and adverse events during follow-up were compared. A total of 145 cases were included in this study. Approximately 56.6% of patients who underwent salvage orchiopexy had testicular atrophy (TA), and the median testicular volume loss of the testes was 57.4%. Age less than 6 years, delayed surgery, and intraoperative poor blood supply were associated with TA in pediatric TT after orchiopexy. Most atrophied testes appeared within 3–6 months after surgery. Compared with the corresponding age-matched healthy controls, the contralateral testicular volumes were larger in the orchiopexy ( P = 0.001 without TA, and P = 0.042 with TA) and orchiectomy groups ( P = 0.033). The adverse events were comparable in patients with orchiectomy or orchiopexy. In summary, follow-up before 3 months after surgery may not offer sufficient clinical value, while that 3 months after surgery should be regarded as the first follow-up time for testicular monitoring. The contralateral testes of patients with TT showed compensatory hypertrophy. We suggest performing orchiectomy when torsed testes are surgically assessed as Arda grade III or inviable.

The Flavonoid Chrysin Protects against Testicular Apoptosis Induced by Torsion/Detorsion in Adult Rats

“…Oxidative stress in testis tissue is very detrimental due to highly unsaturated fatty acids [28]. It has been previously demonstrated that ischemia/reperfusion damages in testis tissue resulted in testis atrophy and reduction of testicular weight [29]. Several studies previously reported reduced serum testosterone levels due to testicular torsion/detorsion process [30,31].…”

Torsión testicular y su afección en la reproductividad

“…La mayoría de investigaciones sugieren que a largo plazo es posible encontrarse con secuelas por el tratamiento, tanto por la orquiectomía como por la orquidopexia (Aggarwal et al, 2022). Los efectos a corto y largo plazo están estrechamente relacionados con la rapidez con las que se brindó un tratamiento; ya que mientras más tiempo se tardó en identificar la TT y llevar a cabo la intervención quirúrgica, fue más difícil salvar el testículo afectado y se mostraron tasas más lentas de recuperación, así como una mayor tendencia a presentar efectos negativos como atrofias testiculares, disminución de la espermatogénesis, bajas concentraciones de testosterona, menos calidad seminal, entre otros (Aggarwal et al, 2022;Yu et al, 2022;. Uno de los efectos adversos frecuentemente observados fue la degeneración testicular acompañada de una reducción del volumen gonadal; considerando que un ochenta y cinco por ciento de la composición masiva del testículo es constituida por estructuras tubulares seminíferas y el volumen testicular es un reflejo de su estado funcional, de acuerdo con Emeka Chukwubuike et al ( 2022), está relacionado con espermatogénesis reducida y fertilidad reducida en la vida adulta.…”