Testicular Torsion: Late Results with Special Regard to Fertility and Endocrine Function

Abstract

Late results were determined for 42 patients who had undergone detorsion and fixation for unilateral testicular torsion in the prepubertal and pubertal age. Exocrine and endocrine function for the testes was determined in 30 patients who had reached postpuberal age. Patients who underwent detorsion and fixation 8 hours or less after the onset of symptoms had normal-sized testicles and only slight changes in testicular morphology. When treatment was delayed and detorsion was done more than 8 hours later a marked decrease was observed in testicular size. The exocrine function in patients with torsion was reduced. The semen quality, as judged by 2 semen analyses, was normal in 15 patients, doubtful in 3 and pathological in 12. Even when detorsion was done 4 hours or less after the onset of symptoms the exocrine function of the testes was normal in only 50 per cent of the cases. In patients with doubtful and pathological sperm analyses higher follicle-stimulating and luteinizing hormone levels were observed.

Parental perception of acute scrotal pain in children

“…2 Surgery after this time is more likely to result in an orchidectomy owing to irreversible infarction, with a subsequent decrease in fertility and hormonal function. [3][4][5] Since prompt presentation, diagnosis and treatment are critical for testicular salvage, multiple patient and hospital specific factors may influence orchidectomy rates. Orchidectomy rates vary widely in the literature, ranging from 39% to 71% in most series.…”

The dilemma in the diagnosis of acute scrotum: clinical clues for differentiating between testicular torsion and epididymo-orchitis

“…Second, several studies have disclosed that if a twisted testis is not removed, a reduced sperm count is not uncommon. (11)(12)(13) In our study, the pain duration was significantly different between groups. Testicular ischemia typically presents with sharp pain and epididymo-orchitis presents with indolent or slowly progressive pain.…”

Escroto agudo

“…Portanto este exame isolado não tem valor absoluto no diagnóstico. Existem dois exames principais que podem mostrar a anatomia do cordão e o fl uxo sangüíneo, são a ultra-sonografi a com Doppler do escroto e a cintilografi a escrotal com emprego de tecnésio 99m 6,8 . A ultra-sonografi a com Doppler é um exame pouco invasivo, de custo acessível, fácil acesso, rápido, mostrando uma sensibilidade de 89,9% e especifi cidade de 98,8% em mãos experientes.…”