Testicular torsion: a race against time

Kapoor, Shailendra

doi:10.1111/j.1742-1241.2008.01727.x

Cited by 118 publications

(128 citation statements)

References 71 publications

(73 reference statements)

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“…Visiting a doctor in case of urgency is typical for patients as boys, especially adolescents, experience excessive shyness concealing their illness [8,13]. Delayed treatment leads to late hospitalization and, consequently, the loss of the organ [11,12]. The diversity of therapeutic tactics indicates the lack of a unified approach to treating patients with TT.…”

Section: Our Experience In Treatment Of Testicular Torsion In Childrementioning

confidence: 99%

Our Experience in Treatment of Testicular Torsion in Children

et al. 2017

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The objective of the research was to analyze personal experience and world literature on the diagnosis and treatment of boys with testicular torsion and to improve the process of providing specialized care. Problem statement and analysis of the recent researchTesticular torsion (TT) is an emergency condition caused by twisting of the spermatic cord which results in strangulation of the blood supply leading to testicular infarction and organ loss [5,9,10,14]. TT is one of the most common acute conditions accompanied by syndrome of hyperemic and swollen scrotum [1,3,4,6]; it is reported to occur in approximately 90% of adolescents [2,7]. The objective of the research was to analyze personal experience and world literature on the diagnosis and treatment of boys with TT and to improve the process of providing specialized care. Materials and methods of the researchThe results of diagnosis and treatment of 141 children with TT who were treated in the surgical department of the IvanoFrankivsk Regional Children's Clinical Hospital over a period of 10 years (2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016) were analyzed. The patients' age ranged within 1 month to 18 years. All the boys were hospitalized to the emergency department and examined: a complete anamnesis was collected, testicular examination and Doppler ultrasound examination were performed, the organs of the scrotum were palpated. In addition, all children underwent a standardized clinical examination. Results of the research and their discussionThere was a tendency toward the increase in the incidence of pathology during the following years (2007 -9 cases, 2008 -12 cases, 2009 -13 cases, 2010 -9 cases, 2011 -18 cases, 2012 -10 cases, 2013 -11 cases, 2014 -14 cases, 2015 -19 cases, 2016 -26 cases). Torsion of the left testicle was observed in 98 (70%) boys; torsion of the right testicle was found in 43 (30%) boys. Torsion of cryptococcal testicle was detected in 18 (12.8%) children. 1 (0.7%) child was at the age of 0 -1 months; 15 (10.6%) children were at the age of 1 month -1 year; 13 (9.2%) children were at the age of 1-3 years; 11 (7.8%) children were at the age of 3-6 years; 16 (11.3%) children were at the age of 6-12 years old; 85 (60.3%) children were at the age of 12-18 years. The degree of twisting of the testicle ranged from 180 to 10800. In 133 cases, surgery was performed (44 (33.3%) children underwent detorsion, ipsilateral and contralateral orchiopexy; 29 (21.9%) children underwent orchiectomy with contralateral orchiopexy, 24 (18.1%) boys underwent orchiectomy, 24 (18.1%) boys underwent orchiopexy and in 12 (9.09%) cases, detorsion was performed); manual testicular detorsion was attempted in 8 (5.7%) cases only. Only 24 (17%) children were hospitalized timely (up to 6 hours). In this group, 18 boys were surgically treated, 3 boys underwent detorsion, and in 4 cases, manual detorsion was attempted.64 (45.4%) children were examined 7-24 hours after TT. In this group, the auxiliary procedures including heating of the

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Section: Our Experience In Treatment Of Testicular Torsion In Childrementioning

confidence: 99%

Our Experience in Treatment of Testicular Torsion in Children

et al. 2017

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“…It has been demonstrated in animal models that a number of substances have some benefit at reducing testicular reperfusion injury (18). The current study used papers from the National Center For Biotechnology Information database (https://www.…”

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confidence: 99%

Medical perspective in testicular ischemia-reperfusion injury

Arena

Iacona

Antonuccio

et al. 2017

Experimental and Therapeutic Medicine

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Abstract. Testicular torsion or torsion of the spermatic cord is one of the most serious urological conditions. It causes testicular injury, which potentially leads to male subfertility. The turning of the spermatic cord and spermatic structures around themselves results in biochemical and histological changes; however, following testicular detorsion, tissues undergo reperfusion that causes more severe damage than that induced by ischemia. Since the primary causes of testicular damage are reactive oxygen species production, an increase in intra-mitochondrial calcium concentration and an increased rate of cellular apoptosis, different medications may potentially be effective. It seems that several medications, experimentally and sometimes clinically, serve an adjuvant role in the cellular damage that occurs following ischemia-reperfusion. Antioxidants, calcium channel blockers, phytotherapeutical medicinals, anaesthetics, hormones and platelet inhibitors may potentially create a solid basis for an adjuvant restoring therapy and ameliorate testicular function following torsion. The current study aimed to review the relevant literature and discuss the actions of a number of molecules that may protect the testes during ischemia/reperfusion injury.

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“…Several authors agree that adolescent patients presenting with testicular swelling, while those above this age range appeared as orchitis. [10] [17] The range of age in our study population covers both adolescents and adults. Our results indicated that there was no significant difference between age groups versus diagnosis.…”

Section: Cremasteric Reflexmentioning

confidence: 99%

“…If surgical options are delayed, then manual detorsion should be attempted. [10] Thus, the aim of this study is to survey the clinical findings and outcome of the patients treated for testicular torsion in Sree Balaji Medical College and Hospital, Chennai-44.…”

Section: Introductionmentioning

confidence: 99%

A Retrospective Study of Torsion of Testis - Presentation and Its Management in Our Institution

Karthikeyan¹,

Ashiq²,

J³

et al. 2016

jemds

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BACKGROUNDTesticular torsion is a surgical emergency, which requires early diagnosis and prompt surgical management to avoid testicular damage. The aim of this study is to survey the clinical findings and outcome of the patients treated for testicular torsion in our Institution, Sree Balaji Medical College and Hospital, Chennai -44. In this cross-sectional study, a retrospective survey of all cases presenting with acute scrotum and primarily diagnosed as testicular torsion was conducted during 2012 and 2015 in our Institution. All 32 cases were reviewed and several clinical data including duration of symptoms and operative findings were collected. Misdiagnosing testicular torsion can lead to organ loss, cosmetic deformity and compromised fertility. The differential diagnosis of the acutely painful scrotum includes testicular torsion, trauma, epididymitis/orchitis, incarcerated hernia, varicocele, idiopathic scrotal oedema and torsion of the appendix testis.

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Testicular torsion: a race against time

Cited by 118 publications

References 71 publications

Our Experience in Treatment of Testicular Torsion in Children

Our Experience in Treatment of Testicular Torsion in Children

Medical perspective in testicular ischemia-reperfusion injury

A Retrospective Study of Torsion of Testis - Presentation and Its Management in Our Institution

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