Asynchronous bilateral torsion of the spermatic cord in the newborn is extremely rare. We report such a case in a 4-day-old boy with subsequent operative discovery of prior in utero torsion of the contralateral spermatic cord. The diagnosis was made by physical examination, transillumination test, color Doppler ultrasound, and confirmed by emergent surgical exploration. To our knowledge, the present case is the 6th case of asynchronous bilateral torsion of the spermatic cord in the English literature, and the first case in Korea.
Humans ; Infant, Newborn ; Male ; Spermatic Cord Torsion/*diagnosis/pathology/surgery ; Testis/pathology

OBJECTIVETo improve the early diagnosis and therapeutic outcomes of testicular torsion.

METHODSWe retrospectively reviewed the clinical data of 49 cases of testicular torsion along with the results of their intratesticular color Doppler flow imaging (CDFI) and spermatic cord sonography.

RESULTSOf the 49 cases, 42 showed abnormal intratesticular blood flow, including 3 cases of increased blood flow, while the other 7 presented no obvious abnormality. Morphological abnormality of the spermatic cord was found in 47 cases. Twenty-eight cases underwent testis removal, and the other 21 received detorsion and orchidopexy, in which 12 testes were preserved with normal size and blood flow.

CONCLUSIONSpermatic cord sonography and intratesticular CDFI play an important role in the early diagnosis of testicular torsion. And early surgical exploration contributes to the preservation of the testis.

Adolescent ; Adult ; Child ; Early Diagnosis ; Humans ; Male ; Middle Aged ; Orchiopexy ; Retrospective Studies ; Spermatic Cord ; diagnostic imaging ; Spermatic Cord Torsion ; diagnostic imaging ; surgery ; Ultrasonography, Doppler ; Young Adult

OBJECTIVETo improve the diagnosis and treatment of testicular torsion.

METHODSThe clinical features of 49 testicular torsion patients admitted to Department of Urology Nanjing Drum Tower Hospital from April 2008 to March 2014 were retrospectively analyzed, the average age was (21 ± 6) years (range 13-52 years).Forty-four cases underwent the color Doppler flow imaging of scrotum, demonstrated reduction of the testicular blood supply in 9 cases and loss of the testicular blood supply in 35 cases. Orchiectomy or orchiopexy was performed according to the testicular blood supply, the contralateral testis fixation was performed in all patients. A two-tailed Student's t-test was used to compare the data between two groups, Pearson correlation analysis was used to analyze the correlation of diurnal temperature and number of cases.

RESULTSAll the patients with testicular torsion were Tunica-reversed, 38 (77.5%) cases occurred from November to April. The monthly incidence of testicular torsion was positively correlated with diurnal temperature (r = 0.6434, P = 0.024). Forty-four cases underwent the color Doppler flow imaging, demonstrated the reduction or loss of the testicular blood supply, and these patients were confirmed to be testicular torsion by surgical exploration. The salvage rates of testis in patients with testicular torsion were 2/2, 5/15, 2/9 and 4.2% (1/24) in those seeking medical attention within 6, 12, 24 hours and over 24 hours after the onset of pain. All the patients were followed up for 3 to 75 months, and no one experienced recurrent torsion.

CONCLUSIONSThe incidence of testicular torsion is higher during the spring and winter, diurnal temperature change is associated with testicular torsion. The diagnostic rate of color Doppler flow imaging is high, which can be chosen as the primary method. Prompt recognition and treatment are necessary for testicular salvage.

Adolescent ; Adult ; Humans ; Incidence ; Male ; Middle Aged ; Orchiectomy ; Retrospective Studies ; Scrotum ; surgery ; Seasons ; Spermatic Cord Torsion ; diagnosis ; epidemiology ; Temperature ; Testis ; surgery ; Young Adult

OBJECTIVETo explore the early diagnosis of testicular torsion in children.

METHODSThe clinical data of 24 patients with testicular torsion were analyzed retrospectively.

RESULTSThe patients ranged in age from 4 months to 15 years ( mean 10.3 years), 17 left and 7 right testes involved. The duration between the onset and operation varied from 1 hour to 4 months. Diagnoses were initially and correctly made in 16 cases and delayed in 8. Surgical explorations were carried out in 23 cases, and resection of the testis performed in 17.

CONCLUSIONTesticular necrosis is associated not only with the duration and degree, but also with the extent of the torsion. Color Doppler has clinical value in the early diagnosis of child testicular torsion. Timely surgical exploration should be performed for cases of acute scrotal problem suspected of child testicular torsion.

Adolescent ; Child ; Child, Preschool ; Early Diagnosis ; Humans ; Infant ; Male ; Orchiectomy ; Retrospective Studies ; Spermatic Cord Torsion ; diagnostic imaging ; surgery ; Ultrasonography, Doppler, Color

Scrotal pain is a common complaint in a urological practice. Its diagnosis can prove challenging in both acute and chronic forms and requires a thorough and complete history and physical examination. This article discusses the evaluation and management of several entities of scrotal pain, including testicular torsion, epididymitis, postvasectomy pain, varicocele, and chronic orchialgia.
Diagnosis, Differential ; Epididymitis/*diagnosis/drug therapy ; Humans ; Male ; Pain/*diagnosis ; *Pain Management ; Pain, Postoperative ; Physical Examination ; *Scrotum ; Spermatic Cord Torsion/*diagnosis/surgery ; Testis/physiopathology ; Varicocele/*diagnosis/physiopathology/therapy ; Vasectomy

Testicular torsion is a surgical emergency in the field of urology. Knowledge of the epidemiology and pathophysiology is significant to an urologist. However, the epidemiology of testicular torsion in Korea has not been studied. We performed a nationwide epidemiological study to improve knowledge of the epidemiology of testicular torsion. From 2006-2011, the Korean Urologic Association began the patient registry service. The annual number of patients with testicular torsion from 2006 to 2011 were 225, 250, 271, 277, 345, and 210, respectively. The overall incidence of testicular torsion in males was 1.1 per 100,000; However, the incidence in men less than 25 yr old was 2.9 per 100,000. Adolescents showed the highest incidence. Total testicular salvage rate was 75.7% in this survey. There was no geographic difference of testicular salvage rate. Minimizing the possibility of orchiectomy for testicular torsion is important to improve public awareness to expedite presentation and provider education to improve diagnosis and surgery.
Adolescent ; Age Distribution ; Child ; Child, Preschool ; Humans ; Incidence ; Infant ; Infant, Newborn ; Korea/epidemiology ; Male ; Orchiectomy/*statistics & numerical data ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Spermatic Cord Torsion/diagnosis/*epidemiology/*surgery ; Treatment Outcome ; Young Adult