OBJECTIVETo improve the diagnosis and treatment of testicular torsion.

METHODSThe clinical data of 9 cases of suspected testicular torsion were restrospectively analyzed to summarize the diagnostic experiences.

RESULTSThe 9 patients were 12-27 (mean 15) years old, 8 treated by surgery and 1 by spontaneous detorsion under anesthesia. Among them, 7 cases were proved to be testicular torsion and 1 case was acute epididymitis. Of the 7 cases of testicular torsion, 6 were found to have 180-720-degree torsion around the spermatic cord and 1 case 180-degree around the verticality of the spermatic cord. The accuracy rate of color ultrasonic examination was 87.5%.

CONCLUSIONPatients with acute scrotum pain should have color ultrasonic examination. Not all cases of the disease had testicular torsion around the spermatic cord. Emergency operation should be performed on any suspected case of testicular torsion.

Adolescent ; Adult ; Child ; Humans ; Male ; Spermatic Cord Torsion ; etiology ; therapy

Schoenlein-Henoch syndrome (SHS), one of the manifestations of systemic vasculitis, usually involves the skin, gastrointestinal tract, joints and kidney. Since the involvement of male genitalia is very rare and there is little mention of it in textbooks, doctors have a tendency to neglect this finding in SHS. Unless there is a confirming diagnosis, it is easily mistaken for testicular torsion and the patients undergo unnecessary operations because they complain of unbearable scrotal pain. SHS is not uncommon in Korea, but hardly any cases of scrotal involvement are found. We have experienced 7 cases of acute scrotum associated with SHS admitted to Severance Hospital, Yonsei University College of Medicine during the last 20 years; 2 underwent operation and 5 received conservative treatment only.
Acute Disease ; Case Report ; Child ; Child, Preschool ; Edema/etiology* ; Epididymitis/etiology* ; Human ; Male ; Purpura, Schoenlein-Henoch/complications* ; Scrotum* ; Spermatic Cord Torsion/therapy ; Spermatic Cord Torsion/etiology*

Testicular torsion has been estimated to affect 1 in every 4 000 males younger than the age of 25 years and has peaks of incidence occurring in the neonate and the adolescent entering puberty. The incidence of missed testicular torsion was about was 4%. The incidence of missed non-simultaneous bilateral torsion was unknown. We presented a case of missed bilateral testicular torsion with resulting primary testicular failure and hypogonadism with erectile dysfunction. The patient was seen for infertility and erectile dysfunction 10 years after the testicular torsion. Semen analysis revealed azoospermia. Serum total testosterone was at the castration level (0.14 nmol/L). His infertility was irreversible. His erectile dysfunction was managed successfully with testosterone replacement and use of sildenafil.
Adult ; Diagnostic Errors ; Erectile Dysfunction ; diagnosis ; etiology ; Humans ; Infertility, Male ; diagnosis ; etiology ; Male ; Spermatic Cord Torsion ; complications ; diagnosis ; Testosterone ; blood