Les torsions sur testicules cryptorchides

Abstract

RésuméBut : La cryptorchidie est une pathologie assez fréquente en urologie. Elle est associée à un risque élevé d'infertilité et de dégé-nérescence. Elle semble aussi être associée à un risque important de torsion. Cette entité est très peu abordée dans la littérature. Nous rapportons tous les cas de torsion sur testicule cryptorchide observés à notre service dans le but de mieux caractériser cette pathologie et de réduire ainsi le taux d'orchidectomies. AbstractPurpose: Cryptorchidism is a rather frequent pathology in urology. It is associated with a high risk of infertility and degeneration. It also seems to be associated with a high risk of torsion. This entity is poorly studied in the literature. We studied the cases of torsion on cryptorchid testicles hospitalized at our service, to better characterize this pathology and reduce the rate of orchidectomy. Methods: We underwent a retrospective study of all the cases of torsion on a cryptorchid testicle hospitalized in our service of urology between 1999 and 2007. Results: The age of patients was between 7 months and 39 years. Torsion touched the right testicle in 53% of the cases. Patients experienced a brutal pain of the inguinal area with an under cutaneous mass inflammatory and a painful and empty homolateral scrotum. In 60% of the cases, the diagnosis was late and an orchidectomy was carried out. In the other cases, a lowering of the testicle was done with the controlateral orchidopexy. Conclusion: Even though torsions on a cryptorchid testicle are rare, we should not ignore them. The early diagnosis will make it possible to save and lower the testicle, and track a possible degeneration.

Acute Abdomen Revealing an Unusual Case of Intra-Abdominal Testicular Torsion

“…Gerster was the rst author to report a similar case in 1898 [8,12,13]. An intra-abdominal testis has a greater risk of torsion than that which is normally descended, because of lack of anatomical attachment structures, the absence of gubernaculum, the size of the spermatic cord which is not in adequacy with the size of the testicle which is o en atrophic [2,10].…”

“…e cryptorchidism is de ned as an undescended testis into the scrotum [1][2][3][4][5]. It a ects 1-5% of term births and between 1.1 and 45% of premature infants [1,6,7].…”

“…It a ects 1-5% of term births and between 1.1 and 45% of premature infants [1,6,7]. e main complications of this condition are testicular torsion, malignancy, infertility, and exposure to trauma [2,6,7]. e intra-abdominal position of the testis is rare and must be evoked ahead of any vacuity of the scrotum with a nonpalpable testis in the inguinal canal [3].…”

“…Intraabdominal testicular torsion is a rare surgical emergency involving the functional prognosis of the testis [6,8]. It is manifested by an atypical clinical picture dominated by an abdominal symptomology which is a source of diagnostic delay [2,9,10]. Its management is also controversial when the testis is viable [2].…”

“…It is manifested by an atypical clinical picture dominated by an abdominal symptomology which is a source of diagnostic delay [2,9,10]. Its management is also controversial when the testis is viable [2]. We report here our experience of the management of spermatic cord torsion on intra-abdominal testis discovered during an acute surgical abdomen.…”