Unilateral torsion of the testis was experimentally induced in Sprague-Dowley rats by an incision in the scrotum and manual rotation of the testis. The testes remained torted for 3 or 24 hours and then were released by detorsion or orchiectomy. Histologic changes were evaluated 2 weeks and 4 weeks post torsion episode in order to answer the following questions:(1) Does the duration of testicular torsion affect the degree of histologic change in the contralateral testis? (2) Does the treatment of the torted testis influence the contralateral testis histologically? (3) Are there any histologic differences according to the duration of the follow-up in each group? The results indicate that when a torted testis was kept in place for at least 24 hrs, then was a marked decrease in spermatogenesis, but even this histologic change disappeared 4 weeks later. In conclusion a torted testis may present a liability to the patient's contralateral testis, but this phenomena is temporal.
Animal ; Male ; Rats ; Rats, Inbred Strains ; Spermatic Cord Torsion/complications ; Spermatic Cord Torsion/pathology*

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 observe the hemodynamic and histological effects of unilateral testicular torsion on the contralateral testis in immature rats, and compare the results of different treatments.

METHODSTesticular torsion models were established in 3-week-old rats and randomized into a normal control, a testicular torsion, a reposition and an orchiectomy group. The systolic peak velocity of the right testicular artery was measured by color Doppler before and 8, 12, 24 and 72 h after the operation. Histological observations of the right testes were performed 2 h after testicular torsion, 12 h after testicular reposition and orchiectomy and when the rats were 9 weeks old.

RESULTSThe blood supply of the immature right testes increased continuously after testicular torsion of the left side. Interstitial edema and ultrastructure changes were observed in the testicular torsion, reposition and orchiectomy groups. The right testis weight was significantly greater in both the testicular torsion and orchiectomy groups than in the normal control group of the 9-week-old rats (P < 0.01). No significant differences were noted in the right testicular seminiferous tubule diameter (STD) , count measure spermatogenic (CMSE) and testicular biopsy score (TBS) among the four groups (P > 0.05).

CONCLUSIONUnilateral testicular torsion increases blood supply and induces histological changes in the contralateral testis in immature rats. Reposition and orchiectomy following light injury are prognostic of similar results.

Animals ; Male ; Rats ; Rats, Wistar ; Spermatic Cord Torsion ; diagnostic imaging ; pathology ; Testis ; blood supply ; pathology ; Ultrasonography

No abstract available.
Humans ; Lymphocyte Count/*methods ; Male ; Neutrophils/*pathology ; *Spermatic Cord Torsion ; *Testis

No abstract available.
Humans ; Lymphocyte Count/*methods ; Male ; Neutrophils/*pathology ; *Spermatic Cord Torsion ; *Testis

Polyorchidism is an uncommon congenital anomaly, which is defined as the presence of more than two testes, and may be associated with urological pathologies, such as an undescended testis, inguinal hernia, testicular torsion and testicular tumor. In the absence of any concomitant disorder, and if testicular tumor can be ruled out, using magnetic resonance imaging and ultrasonography, then a surgical exploration or biopsy is unnecessary. We report a case of polyorchidism in a 3 year-old-boy, with three testes in the right scrotum.
Biopsy ; Cryptorchidism ; Hernia, Inguinal ; Magnetic Resonance Imaging ; Male ; Pathology ; Scrotum ; Spermatic Cord Torsion ; Testis ; Ultrasonography

OBJECTIVETo improve clinicians' ability of diagnosing testicular torsion.

METHODSWe reviewed the data of a case of testicular torsion that resulted in necrosis because of delayed presentation and repeated misdiagnosis, and analyzed its anatomic features, clinical manifestations, ultrasound results, the causes of misdiagnosis and relevant literature.

RESULTSThe patient presented 5 hours after the onset of symptoms, complaining of severe paroxysmal pain in the lower left abdomen, accompanied with nausea and vomiting, and was twice misdiagnosed as having enterospasm or ureteral calculus at two different hospitals. Fifteen hours later, surgical exploration revealed an about 900-degree testicular torsion in the spermatic cord, which necessitated orchiectomy for non viability of the testis. Postoperative pathological examination confirmed testicular necrosis and diffused hemorrhage in the testis and epididymis.

CONCLUSIONTimely presentation, correct diagnosis and proper treatment are keys to saving the affected testis. Color Doppler ultrasound is an ideal option for the definite diagnosis of acute scrotal diseases, and it offers a valuable guidance for related surgery as well.

Adult ; Diagnostic Errors ; Humans ; Male ; Necrosis ; Spermatic Cord Torsion ; diagnosis ; Testis ; pathology

OBJECTIVETo investigate the protective effect of retarded removal of the unilateral necrotic testis after long-time (> 24 h) spermatic cord torsion on the contralateral testis in rats.

METHODSThirty-three male SD rats aged 21 -42 days were divided into a sham-operation group (n = 11), a torsion-reservation group (n = 12) and a torsion-orchiectomy group (n = 10). The rats of the sham-operation group received dartos pouch orchidopexy on the left testis, while those of the latter two groups underwent 720 degrees unilateral spermatic cord torsion on the left side. Ninety-six hours later, the rats of the torsion-reservation group received detorsion with the ipsilateral testis preserved, while those of the torsion-orchiectomy group underwent orchiectomy. Three months after operation, blood samples were obtained from the rats for measurement of serum testosterone and antisperm antibodies by ELISA, and meanwhile testes and epididymides were harvested for determination of the volumes of various structures and the diameter of seminiferous tubules with stereological methods.

RESULTSThere were no significant differences in the level of serum testosterone among the three groups. Anti-sperm antibody positive was found in only 1 animal in the torsion-reservation group. The Leydig cell nuclei in the contralateral testis appeared larger in the torsion groups than in the sham-operation group. Marked morphological changes were observed in 1, 3 and 0 of the animals in the sham-operation, torsion-reservation and torsion-orchiectomy group, respectively, mainly including atrophy of seminiferous tubules and reduced number of spermatogenic cells. The volume of the contralateral testis was increased by 19% and 21% in the torsion-reservation and torsion-orchiectomy group, respectively, in comparison with that in the sham-operation group (P < 0.05). No significant differences were observed in the volume of seminiferous tubules of the contralateral testis among the sham-operation, torsion-reservation and torsion-orchiectomy groups ([1.15 +/- 0.07], [1.30 +/- 0.04] and [1.35 +/- 0.05] cm3). The volume of the interstitial tissue was significantly increased in the latter two groups ([0.36 +/- 0.02 and 0.34 +/- 0.03] cm3) as compared with the former ([0.25 +/- 0.02] cm3) (P < 0.05). The diameters of the seminiferous tubules exhibited no significant differences among the three groups ([226.00 +/- 7.00], [223.00 +/- 6.00] and [221.00 +/- 3.0] microm).

CONCLUSIONLong-time unilateral spermatic cord torsion may result in compensatory hypertrophy of the contralateral testis, and orchiectomy does not significantly affect the histology of the contralateral testis and epididymis.

Animals ; Epididymis ; pathology ; Male ; Necrosis ; Orchiectomy ; Rats ; Rats, Sprague-Dawley ; Spermatic Cord Torsion ; pathology ; surgery ; Testis ; pathology ; surgery

Acute scrotal pain is a common urologic presentation and critical pathology due to the possibility of organ loss in the emergency department. Referred pain in the lower quadrant of the abdomen may accompany testicular torsion. Of 58 patients with testicular torsion between January 2001 and March 2011, three visited the emergency department with abdominal pain alone. The median age of the patients was 16 years (range, 13-19). Median duration of abdominal pain to first medical examination and proper diagnosis by an urologist was 14 hours (range, 2-168) and 77 hours (range, 57-240), respectively. All patients underwent orchiectomy. Due to symptomatic variations for testicular torsion, all clinicians providing emergency care to patients who have referred pain in the lower abdomen without scrotal pain should consider the constellation of symptoms in order to avoid superfluous diagnostic delay.
Abdomen ; Abdomen, Acute* ; Abdominal Pain ; Diagnosis ; Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Orchiectomy ; Pain, Referred ; Pathology ; Spermatic Cord Torsion*

Acute scrotal pain is a common urologic presentation and critical pathology due to the possibility of organ loss in the emergency department. Referred pain in the lower quadrant of the abdomen may accompany testicular torsion. Of 58 patients with testicular torsion between January 2001 and March 2011, three visited the emergency department with abdominal pain alone. The median age of the patients was 16 years (range, 13-19). Median duration of abdominal pain to first medical examination and proper diagnosis by an urologist was 14 hours (range, 2-168) and 77 hours (range, 57-240), respectively. All patients underwent orchiectomy. Due to symptomatic variations for testicular torsion, all clinicians providing emergency care to patients who have referred pain in the lower abdomen without scrotal pain should consider the constellation of symptoms in order to avoid superfluous diagnostic delay.
Abdomen ; Abdomen, Acute* ; Abdominal Pain ; Diagnosis ; Emergency Medical Services ; Emergency Service, Hospital ; Humans ; Orchiectomy ; Pain, Referred ; Pathology ; Spermatic Cord Torsion*