Testicular torsion in the inguinal canal in children

• Published in: Journal of pediatric urology Vol. 9; no. 6; pp. 793 - 797
• Main Authors: Pogorelić, Zenon, Mrklić, Ivana, Jurić, Ivo, Biočić, Mihovil, Furlan, Dubravko
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2013
• Subjects: Adolescent; Child; Child, Preschool; Children; Cryptorchidism; Cryptorchidism - diagnostic imaging; Cryptorchidism - pathology; Cryptorchidism - surgery; Follow-Up Studies; Humans; Infant; Infant, Newborn; Inguinal canal; Inguinal Canal - diagnostic imaging; Inguinal Canal - surgery; Male; Necrosis - diagnostic imaging; Necrosis - pathology; Orchiectomy; Orchiopexy; Pediatrics; Spermatic cord torsion; Spermatic Cord Torsion - diagnostic imaging; Spermatic Cord Torsion - pathology; Spermatic Cord Torsion - surgery; Testicular torsion; Testis - diagnostic imaging; Testis - pathology; Testis - surgery; Ultrasonography, Doppler; Undescended testis; Urology; Testicular torsion; Spermatic cord torsion; Cryptorchidism; Undescended testis; Children; Inguinal canal
• ISSN: 1477-5131; 1873-4898
• DOI: 10.1016/j.jpurol.2012.10.013

Abstract Objective To evaluate the management and outcomes of pediatric patients presenting with torsion of an undescended testis in the inguinal canal. Patients and methods The case records of 84 children operated on for testicular torsion were retrospectively reviewed. The medical records included initial medical history, physical examination, operative findings, and the results of follow-up. The diagnosis of torsion of undescended testis was made clinically and confirmed by a Doppler ultrasound and inguinal canal exploration. Results Eight children were operated following torsion of undescended testis. In four cases the testicle was preserved and orchidopexy was performed, while in four cases orchidectomy was performed due to testicular gangrene. Mean duration of symptoms, at time of surgery, in the orchidopexy group was 6 h and in the orchidectomy group was 50 h. At follow-up atrophy of the testis was found in only one patient. Conclusion Torsion of an undescended testis is a relatively rare phenomenon that should be suspected, diagnosed and treated without delay. This study highlights the importance of examination of external genital organs. With improved recognition of this entity and earlier referrals of patients with undescended testes by primary care physicians, its occurrence might eventually be prevented.