Manual testicular detorsion aided by color Doppler ultrasonography.

Cannon, Mary L.; Finger, Michael; Bulas, Dorothy

doi:10.7863/jum.1995.14.5.407

Cited by 12 publications

(2 citation statements)

References 1 publication

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“…The TT can be lateral, outward, median or inward [28,29,30]. There are no established parameters to determine the direction of TT [31]. In 60-70% of cases, torsion occurs in the midline and in 30% in the lateral line [32,33,34].…”

Section: Discussionmentioning

confidence: 99%

The Importance of Manual Detorsion in Intravaginal Testicular Torsion

Anastasakis¹,

Gkalonaki²,

Doitsidis³

et al. 2023

Acta Medica Bulgarica

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Objective The aim of the present prospective clinical study was to highlight the importance of the proper application of the manual detorsion (MD) in cases of intravaginal testicular torsion. Major complications such as ischemia, reperfusion injury and testicular compartment syndrome could be avoided. Materials and Methods From January 2017 to February 2018, 26 boys aged between 8 and 16 years underwent surgical treatment for intravaginal testicular torsion (ITT) (14 left- and 12 right-sided). Diagnosis was made upon clinical criteria (both symptoms and signs); sudden onset of scrotal pain (n = 26, 100%), nausea and vomiting (n = 25, 96,15%), abdominal pain (n = 3, 11,53%), high testicular position (n = 21, 80,77%), absence of the cremasteric reflex (n = 26, 100%), harshness of the twisted testicle (TT) (n = 24, 87.5%), alteration on axis or orientation of the TT (n = 24, 94,31%), and pain during palpation (n = 26, 100%). Two cases presented with neglected scrotum leading to inability to evaluate the intrascrotal structures. Major ultrasonographic findings were the following: absence of perfusion, heterogeneity of the parenchyma and identification of the Whirlpool sign. Therefore, our study group consisted of 15 out of the 26 cases, in which the initial assessment at the Emergency Department occurred within the first 3-7 hours after the onset of ITT. Results Based on high clinical suspicion and ultrasonographic documentation of the ITT, MD was performed in all those cases. Pain alleviation followed immediately, while significant improvement of the clinical picture of the suffering scrotum was also observed. Successful detorsion was documented via ultrasonography. After completion of the preoperative assessment, bilateral orchidopexy was performed. All patients had an uneventful postoperative course and were discharged home on the second postoperative day. Conclusion In conclusion, we hereby document that MD is a safe, non-invasive method, easy to learn for every clinician. It can be applied immediately after the diagnosis of the ITT, converting a highly urgent surgery into an elective one. Of course, surgical exploration of intrascrotal structures constitutes a crucial final step.

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Section: Discussionmentioning

confidence: 99%

The Importance of Manual Detorsion in Intravaginal Testicular Torsion

Anastasakis¹,

Gkalonaki²,

Doitsidis³

et al. 2023

Acta Medica Bulgarica

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“…Color Doppler imaging has been frequently used in the diagnosis of testicular torsion and differential diagnosis of other acute scrotal disorders. It has been also reported that it could be used for the evaluation of testicular perfusion after the preoperative external detorsion in acute testicular torsion [ 3 – 5 ]. However, ultrasonography and color Doppler imaging are operator dependent and might yield inconclusive results [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

The Monitoring of Preoperative External Detorsion with Diffusion-Weighted Imaging in a Patient with Acute Testicular Torsion

Beyazal

Çeliker

İnecikli

et al. 2017

Case Reports in Radiology

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Testicular torsion is one of the main causes of acute scrotum and may result in permanent damage of the testicular tissue. Color Doppler imaging has been frequently used in the diagnosis of testicular torsion and posttreatment follow-up period of the disease. There are some studies reporting the value and usefulness of diffusion-weighted imaging in the diagnosis of testicular torsion. However, to the best of our knowledge, there is no report regarding the monitoring of preoperative external detorsion in testicular torsion with diffusion-weighted imaging examination. In this article, diffusion-weighted imaging findings in the management of preoperative external detorsion in a case with testicular torsion were presented.

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Ultrasound in the assessment of the acute scrotum

Herbener

1996

J. Clin. Ultrasound

101

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Color Doppler imaging (CDI) has become the study of choice in evaluation of the scrotum due to technological advances resulting in superior resolution and sensitive Doppler systems. CDI has become particularly helpful in evaluating the scrotum in the setting of acute disorders, such as torsion of the spermatic cord, epididymal and testicular inflammation, and scrotal trauma. CDI should be the study of choice to evaluate for torsion of the spermatic cord and demonstrates a high degree of accuracy. CDI in such a setting, however, does require operator experience, sensitive Doppler ultrasound equipment, and operator knowledge of the limitations of CDI. With epididymitis or epididymo‐orchitis, CDI has proven to be quite helpful in evaluating the scrotal contents for the presence of inflammation and associated complications. In scrotal trauma, CDI's utility remains somewhat controversial, but with further investigation its appropriate application in this situation may become clear. © 1996 John Wiley & Sons, Inc.

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Manual testicular detorsion aided by color Doppler ultrasonography.

Cited by 12 publications

References 1 publication

The Importance of Manual Detorsion in Intravaginal Testicular Torsion

The Importance of Manual Detorsion in Intravaginal Testicular Torsion

The Monitoring of Preoperative External Detorsion with Diffusion-Weighted Imaging in a Patient with Acute Testicular Torsion

Ultrasound in the assessment of the acute scrotum

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