Spermatic Cord Torsion With Preserved Testis Perfusion: Initial Anatomical Observations

Bentley, Dennis; Ricchiuti, Daniel; Nasrallah, Phillip F.; McMahon, Daniel R.

doi:10.1097/01.ju.0000145527.08591.27

Cited by 57 publications

(39 citation statements)

References 14 publications

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“…Moreover, Bentley et al [15] concluded that boys with testicular torsion who have specific anatomical characteristics such as unusually thick spermatic cord preserve intratesticular flow in the affected testis and are at high risk of misleading findings of torsion if the diagnosis is based solely on color Doppler sonography [15].…”

Section: Discussionmentioning

confidence: 99%

Sonographic appearances of the epididymis in boys with acute testicular torsion but preserved testicular blood flow on color Doppler

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Sonographic appearances of the epididymis in boys with acute testicular torsion but preserved testicular blood flow on color Doppler

et al. 2015

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“…We did not observe any statistically significant difference in the degree of torsion between patients undergoing orchidopexy and those requiring orchidectomy. These anatomical observations can also explain the cases with preserved flow on CDU in spite of the presence of torsion [10]. Initial studies interpreted these cases as false positives [11], but this may not be correct.…”

Section: Discussionmentioning

confidence: 98%

“…Three variables could account for the different effects of torsion on testicular outcome, the degree of torsion, the thickness of the cord and the degree of bell-clapper deformity (attachment of the mesorchium on the testicle) [10]. The latter determines whether torsion will occur, the possible degree of twisting and the likelihood of spontaneous detorsion.…”

Section: Discussionmentioning

confidence: 99%

Predictors of testicular viability in testicular torsion

Cimador

Pace

Castagnetti

et al. 2007

Journal of Pediatric Urology

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Aim: Testicular torsion (TT) requires prompt diagnosis and treatment to avoid testicular loss. Most studies have focused on the ideal work up to rule TT out in cases of acute scrotum. We attempted here to define objective criteria to select between orchidopexy and orchidectomy in patients undergoing surgery for TT. Patients and methods: Fifteen boys with a median age at presentation of 7.8 (range 6.4e12) years undergoing surgical treatment for TT underwent color-Doppler ultrasound (CDU) preoperatively, and a bleeding test intraoperatively. Duration of preoperative history, degree of torsion, CDU findings and degree of bleeding were analyzed. Results: Salvageability was independent of the degree of torsion. In patients with a history longer than 10 h, no flow on CDU and no bleeding, after orchidectomy all the testicles were necrotic on pathology. When all these variables were negative, all the testicles did well during follow up. In the group of patients with no agreement among the analyzed variables, the outcome was unpredictable. Five out of six underwent orchidopexy, but in two cases the testicle atrophied (in spite of flow on CDU in one). Conclusions: No predictive parameters were found for testicular salvageability. Taken as a whole, the parameters studied can be of help in treatment choice. In patients with no agreement among the parameters, orchidopexy seems the appropriate option, but parents should be informed of the risk of testicular atrophy during follow up.

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“…Inflammation is confirmed if increased flow is observed on color Doppler ultrasound. Patients with spermatic cord torsion with preserved testicular perfusion are at particular risk for missed torsion when the diagnosis of torsion is based solely on color flow Doppler findings [1].…”

Section: Discussionmentioning

confidence: 99%

Acute epididymitis in Greek children: a 3-year retrospective study

Sakellaris

Charissis

2007

Eur J Pediatr

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The aim of the study was to compare historical features, physical examination findings, and testicular color Doppler ultrasound in pediatric patients with epididymitis compared to testicular torsion and torsion of the appendix testes. A retrospective review of the medical records of 66 boys presenting with clinical aspects of acute scrotum over a 3-year period was performed. Sixty-six patients were included in the study (29 with epididymitis, 8 with testicular torsion and 12 with torsion of the appendix testis, 4 with scrotal abscesses, 5 with scrotal swelling, and 1 with inflamed epididymal cyst). The duration of symptoms ranged from 6 h to 4 days with a peak on the second day. Urine cultures and viral testes were negative in all patients. Color Doppler ultrasound was diagnostic for epididymitis in 28 patients (96.6%). Systemic intravenous antibiotics were given in all 29 patients with epididymitis. No patient showed signs of testicular atrophy in the follow-up. The increasing incidence of epididymitis should question the policy of routine exploration of the acute scrotum in children. The history and physical examination cannot reliably identify those boys who can be managed conservatively. Color Doppler ultrasound is a useful adjunct in the evaluation of the acute scrotum when physical findings are equivocal but it can also be misleading.

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Spermatic Cord Torsion With Preserved Testis Perfusion: Initial Anatomical Observations

Cited by 57 publications

References 14 publications

Sonographic appearances of the epididymis in boys with acute testicular torsion but preserved testicular blood flow on color Doppler

Sonographic appearances of the epididymis in boys with acute testicular torsion but preserved testicular blood flow on color Doppler

Predictors of testicular viability in testicular torsion

Acute epididymitis in Greek children: a 3-year retrospective study

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