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Komatsu S, Terui K, Takenouchi A, Kawaguchi Y, Nishimura K, Oita S, Yoshizawa H, Takiguchi S, Hishiki T. Indocyanine green fluorescence imaging as a predictor of long-term testicular atrophy in testicular torsion: a pilot study. Surg Today 2024:10.1007/s00595-024-02908-9. [PMID: 39085699 DOI: 10.1007/s00595-024-02908-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 07/16/2024] [Indexed: 08/02/2024]
Abstract
PURPOSE This pilot study evaluated indocyanine green-guided near-infrared fluorescence (ICG-NIRF) imaging of testicular blood flow to predict long-term testicular atrophy after testicular torsion (TT) surgery. METHODS The subjects of this retrospective study were patients who underwent surgery for TT at our hospital between December, 2020 and July, 2022. After detorsion, testicular blood flow was evaluated by ICG-NIRF imaging and classified into three categories: fluorescence detected, no fluorescence detected, and fluorescence detected only in the tunica albuginea vessels. Testicular volume was measured by ultrasonography up to 12 months after surgery to evaluate long-term outcomes. RESULTS Twelve patients were included in this analysis. We found a 100% correlation between the absence of ICG-NIRF signals and subsequent testicular atrophy. In three patients without an ICG-NIRF signal, the median testis size 12 months postoperatively was significantly smaller (16.5% of the contralateral testis; range 13-20%) than that in six patients with an ICG-NIRF signal (96%; 89-115%) (p = 0.013). Mild atrophy (74.5%; 73-76%) was also observed in the three patients for whom an ICG-NIRF signal was detected only in the tunica albuginea vessels. CONCLUSIONS Our pilot study highlights the potential of ICG-NIRF imaging as a prognostic tool for guiding surgical decision-making for patients with TT, by predicting postoperative testicular atrophy.
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Affiliation(s)
- Shugo Komatsu
- Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba City, Chiba, 260-8677, Japan.
| | - Keita Terui
- Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba City, Chiba, 260-8677, Japan
| | - Ayako Takenouchi
- Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba City, Chiba, 260-8677, Japan
| | - Yunosuke Kawaguchi
- Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba City, Chiba, 260-8677, Japan
| | - Katsuhiro Nishimura
- Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba City, Chiba, 260-8677, Japan
| | - Satoru Oita
- Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba City, Chiba, 260-8677, Japan
| | - Hiroko Yoshizawa
- Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba City, Chiba, 260-8677, Japan
| | - Shota Takiguchi
- Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba City, Chiba, 260-8677, Japan
| | - Tomoro Hishiki
- Department of Pediatric Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-Ku, Chiba City, Chiba, 260-8677, Japan
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Zhanghuang C, Wang J, Hang Y, Ji F, Yao Z, Mao R, Wang Z, Yao G, Liu L, Yan B. A novel nomogram to predict testicular torsion in children with acute scrotal pain: a single-center retrospective study in western China. Transl Androl Urol 2024; 13:776-791. [PMID: 38855602 PMCID: PMC11157408 DOI: 10.21037/tau-23-634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/10/2024] [Indexed: 06/11/2024] Open
Abstract
Background Acute scrotal pain (ASP) is the most common urological emergency in pediatrics, and its causes include testicular torsion (TT), testicular appendage torsion, and epididymo-orchitis. Among them, TT requires prompt and accurate diagnosis and urgent surgical exploration to prevent testicular loss. Conservative anti-infective treatment is recommended for epididymo-orchitis, and surgery is considered only when scrotal abscess formation and sepsis occur. Improving the understanding of TT in primary care doctors, early diagnosis, and timely surgical exploration are essential to improve the survival rate of TT and avoid excessive treatment. This study aimed to explore the risk factors for TT in children with ASP and construct a predictive model. Methods Clinical data of children who presented with ASP and underwent emergency scrotal exploration surgery were retrospectively analyzed, including general information, physical examination, laboratory tests, and color Doppler ultrasonography (CDU) findings. Based on surgical exploration, the outcomes were categorized as confirmed TT or not. Results A total of 283 children were included in this study, among whom 134 had TT. The mean age of all patients was 105±47.9 months, with the majority being of Han ethnicity (87.6%) and residing in urban areas (83%). Most patients had normal C-reactive protein levels and negative results in urine routine white blood cell tests (63.3%). After conducting univariate and multivariate logistic regression analyses, we identified laterality, neutrophil count, mean erythrocyte sedimentation rate, epididymal blood flow signal, testicular parenchymal echogenicity, and testicular blood flow signal as independent risk factors influencing the occurrence of TT in ASP patients. Conclusions This study is the report with the largest sample size on the construction of prediction models for ASP in children in southwestern China. The predictive model we developed demonstrated excellent performance and higher accuracy in predicting TT in children compared to the traditional Testicular Workup for Ischemia and Suspected Torsion (TWIST) score. It can assist pediatric surgeons in diagnosing and treating children with ASP.
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Affiliation(s)
- Chenghao Zhanghuang
- Department of Urology, Kunming Children's Hospital Affiliated to Kunming Medical University, Kunming, China
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, China
- Yunnan Key Laboratory of Children's Major Disease Research, Yunnan Province Clinical Research Center for Children's Health and Disease, Kunming Children's Hospital Affiliated to Kunming Medical University, Kunming, China
| | - Jinkui Wang
- Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yu Hang
- Department of Urology, Kunming Children's Hospital Affiliated to Kunming Medical University, Kunming, China
| | - Fengming Ji
- Department of Urology, Kunming Children's Hospital Affiliated to Kunming Medical University, Kunming, China
| | - Zhigang Yao
- Department of Urology, Kunming Children's Hospital Affiliated to Kunming Medical University, Kunming, China
| | - Rui Mao
- Department of Information, Kunming Children's Hospital Affiliated to Kunming Medical University, Kunming, China
| | - Zhiwei Wang
- Department of Urology, Kunming Children's Hospital Affiliated to Kunming Medical University, Kunming, China
| | - Guiping Yao
- Department of Urology, Kunming Children's Hospital Affiliated to Kunming Medical University, Kunming, China
| | - Ling Liu
- Department of Neonatology, Kunming Children's Hospital Affiliated to Kunming Medical University, Kunming, China
| | - Bing Yan
- Department of Urology, Kunming Children's Hospital Affiliated to Kunming Medical University, Kunming, China
- Yunnan Key Laboratory of Children's Major Disease Research, Yunnan Province Clinical Research Center for Children's Health and Disease, Kunming Children's Hospital Affiliated to Kunming Medical University, Kunming, China
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Chen P, Huang W, He Y, Sun M, Sun X, Huang Y, Li S. A nomogram for predicting risk factors of testicular salvage after testicular torsion in children. Int J Urol 2024; 31:568-574. [PMID: 38339874 DOI: 10.1111/iju.15420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 01/24/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES This study aimed to establish a nomogram for predicting the probability of testicular salvage after testicular torsion in children. METHODS We retrospectively collected data of children with testicular torsion who were treated at Shenzhen Children's Hospital between September 2005 and August 2022. Of the training cohort, 113 patients who underwent orchiectomy and five with testicular atrophy after orchiopexy were included in the failed testicular salvage group. Additionally, 37 patients who underwent orchiopexy without postoperative testicular atrophy were included in the successful testicular salvage group. The predictive factors affecting testicular salvage were determined using univariate and multivariate logistic regression analyses; a nomogram was constructed. The nomogram was verified using data from the validation group. RESULTS Using multivariate logistic regression analysis, the independent risk factors of testicular salvage after testicular torsion were symptom duration (p = 0.034), intratesticular blood flow (p = 0.003), spermatic cord torsion degree (p = 0.037), and monocyte count (odds ratio: 0.012, p = 0.036). A nomogram was established based on these four risk factors. In the training cohort, the area under the receiver operating characteristic curve was 0.969. The area under the receiver operating characteristic curve of the verification cohort was 0.965, indicating good discrimination ability of the nomogram. Increased symptom duration without intratesticular blood flow increased the monocyte count and spermatic cord torsion degree and decreased the success rate of testicular salvage. CONCLUSION This prediction model could obtain the corresponding probability of testicular salvage according to the clinical characteristics of different patients with testicular torsion, providing reference for clinicians and parents.
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Affiliation(s)
- Pengyu Chen
- Department of Urology, Shenzhen Children's Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Weipeng Huang
- Department of Critical Care Medicine, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Yingying He
- Department of Urology, Shenzhen Children's Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Mengkui Sun
- Department of Urology, Shenzhen Children's Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Xuerui Sun
- Department of Urology, Shenzhen Children's Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Yiyan Huang
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Shoulin Li
- Department of Urology, Shenzhen Children's Hospital, Shenzhen, Guangdong, People's Republic of China
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Ye Z, Chen H, Liu X, Wei G. Delayed Care Seeking and Outcomes of Testicular Torsion among Children during the COVID-19 Pandemic: A Systematic Review and Meta-Analysis. Eur J Pediatr Surg 2023; 33:377-385. [PMID: 36384233 DOI: 10.1055/s-0042-1758153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Since the onset of coronavirus disease 2019 (COVID-19), stay-at-home orders and fear caused by the pandemic have had a significant effect on the timing and outcomes of testicular torsion. However, the evidence was limited since the study results were inconsistent. This study aims to examine the hospitalization rates, timing, and outcomes of testicular torsion in children before and during the pandemic. MATERIALS AND METHODS Using PubMed, Embase, and Google Scholar databases, we conducted a systematic search and meta-analysis of studies reporting the timing and outcomes of children admitted with testicular torsion before and during the COVID-19 pandemic. Subgroup analyses were conducted to explore possible sources of heterogeneity. RESULT The outcomes of 899 testicular torsion patients from eight studies were evaluated. Our study found an increased hospitalization rate for patients with testicular torsion (incidence rate ratio = 1.60, 95% confidence interval [CI]: 1.27-2.03; p = 0.001). Despite a significant increase in the duration of symptoms during the COVID-19 pandemic (weighted mean difference = 11.04, 95% CI: 2.75-19.33; p = 0.009), orchiectomy rates did not increase (odds ratio = 1.33, 95% CI: 0.85-2.10; p = 0.147). CONCLUSION During the COVID-19 pandemic, hospitalization rates for testicular torsion and the duration of symptoms among children increased significantly. Moreover, the rate of orchiectomy did not increase during the pandemic, indicating that pediatric emergency services have remained efficient and have prevented an increase in the number of orchiectomies performed despite pandemic-related closures and delays in transporting patients to medical care.
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Affiliation(s)
- Zihan Ye
- Department of Urology, Children's Hospital, Chongqing Medical University, Yuzhong, Chongqing, People's Republic of China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, People's Republic of China
| | - Hongsong Chen
- Department of Urology, Children's Hospital, Chongqing Medical University, Yuzhong, Chongqing, People's Republic of China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, People's Republic of China
| | - Xing Liu
- Department of Urology, Children's Hospital, Chongqing Medical University, Yuzhong, Chongqing, People's Republic of China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, People's Republic of China
| | - Guanghui Wei
- Department of Urology, Children's Hospital, Chongqing Medical University, Yuzhong, Chongqing, People's Republic of China
- Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing, People's Republic of China
- Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing, People's Republic of China
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Yen CW, Chang YJ, Ming YC, Gau CC, Wu CT, Lee J. Factors Determining Testicular Torsion and Consequent Orchiectomy in Pediatric Patients Presenting With Scrotal Pain. Pediatr Emerg Care 2023; 39:744-750. [PMID: 37624776 PMCID: PMC10547102 DOI: 10.1097/pec.0000000000003037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
OBJECTIVE Factors associated with testicular torsion (TT) and consequent orchiectomy in patients presenting to pediatric emergency departments (PEDs) with scrotal pain (SP) are not well described. We report the factors predicting TT and consequent orchiectomy in children with SP. METHODS The data on patients (aged ≤18 years) who presented with SP to PEDs at 4 branches of the Chang Gung Hospital through 10 years were analyzed. RESULTS In all, 256 pediatric patients presented with SP. Their mean age was 11.60 ± 4.61 years and 72.7% (n = 186) were aged 10 to 18 years. The pain was left-sided in 54.7% (n = 140) and the interval between SP onset and PED arrival was 22.45 ± 31.27 hours. Overall, 84 (32.8%) patients needed surgery and 72 (28.1%) had TT. Of the patients with TT, 28 (38.9%) patients needed an orchiectomy. After analysis, TT and consequent orchiectomy were associated with a longer interval between SP onset and PED arrival, absent of testicular ultrasonic blood flow, interval between SP onset and surgery of more than 24 hours, and a high degree of TT. None of them experienced recurrent SP symptoms or TT again. CONCLUSIONS The rate of TT in patients presenting to PEDs with an SP was 28.1%, and 38.9% of the patients with TT needed an orchiectomy. Early diagnosis and intervention helped to prevent subsequent orchiectomy in pediatric patients with TT.
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Affiliation(s)
- Chen-Wei Yen
- From the Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yi-Jung Chang
- Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yung-Ching Ming
- Division of Pediatric Surgery, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chun-Chun Gau
- Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Chang-Teng Wu
- From the Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Jung Lee
- From the Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Yu CJ, Zhao J, Luo J, Hong YF, Zhao TX, Wen S, Jiang L, Lin T, He DW, Wei GH, Wu SD. Long-term follow-up results of testicular torsion in children. Asian J Androl 2022; 24:653-659. [PMID: 35259784 PMCID: PMC9809487 DOI: 10.4103/aja2021127] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
A retrospective cohort study was conducted at the Children's Hospital of Chongqing Medical University from November 2004 to December 2020 to investigate the long-term follow-up results after testicular torsion (TT) in children. Boys with TT were divided into the salvage orchiopexy group and the orchiectomy group, and the baseline characteristics, ultrasonographic indications, intraoperative findings, testicular volumes, and adverse events during follow-up were compared. A total of 145 cases were included in this study. Approximately 56.6% of patients who underwent salvage orchiopexy had testicular atrophy (TA), and the median testicular volume loss of the testes was 57.4%. Age less than 6 years, delayed surgery, and intraoperative poor blood supply were associated with TA in pediatric TT after orchiopexy. Most atrophied testes appeared within 3-6 months after surgery. Compared with the corresponding age-matched healthy controls, the contralateral testicular volumes were larger in the orchiopexy (P = 0.001 without TA, and P = 0.042 with TA) and orchiectomy groups (P = 0.033). The adverse events were comparable in patients with orchiectomy or orchiopexy. In summary, follow-up before 3 months after surgery may not offer sufficient clinical value, while that 3 months after surgery should be regarded as the first follow-up time for testicular monitoring. The contralateral testes of patients with TT showed compensatory hypertrophy. We suggest performing orchiectomy when torsed testes are surgically assessed as Arda grade III or inviable.
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Affiliation(s)
- Cheng-Jun Yu
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China,Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing 400014, China,National Clinical Research Center for Child Health and Disorders, Chongqing 400014, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China,Chongqing Key Laboratory of Pediatrics Chongqing, Chongqing 400014, China
| | - Jie Zhao
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China,Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing 400014, China,National Clinical Research Center for Child Health and Disorders, Chongqing 400014, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China,Chongqing Key Laboratory of Pediatrics Chongqing, Chongqing 400014, China
| | - Jin Luo
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China,Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing 400014, China,National Clinical Research Center for Child Health and Disorders, Chongqing 400014, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China,Chongqing Key Laboratory of Pediatrics Chongqing, Chongqing 400014, China
| | - Yi-Fan Hong
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China,Chongqing Key Laboratory of Pediatrics Chongqing, Chongqing 400014, China,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
| | - Tian-Xin Zhao
- Department of Pediatric Urology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou 510620, China
| | - Sheng Wen
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China,Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing 400014, China,National Clinical Research Center for Child Health and Disorders, Chongqing 400014, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China,Chongqing Key Laboratory of Pediatrics Chongqing, Chongqing 400014, China
| | - Li Jiang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China,
Correspondence: Dr. L Jiang () or Dr. SD Wu ()
| | - Tao Lin
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China,Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing 400014, China,National Clinical Research Center for Child Health and Disorders, Chongqing 400014, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China,Chongqing Key Laboratory of Pediatrics Chongqing, Chongqing 400014, China,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
| | - Da-Wei He
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China,Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing 400014, China,National Clinical Research Center for Child Health and Disorders, Chongqing 400014, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China,Chongqing Key Laboratory of Pediatrics Chongqing, Chongqing 400014, China,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
| | - Guang-Hui Wei
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China,Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing 400014, China,National Clinical Research Center for Child Health and Disorders, Chongqing 400014, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China,Chongqing Key Laboratory of Pediatrics Chongqing, Chongqing 400014, China,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
| | - Sheng-De Wu
- Department of Urology, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China,Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing 400014, China,National Clinical Research Center for Child Health and Disorders, Chongqing 400014, China,China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China,Chongqing Key Laboratory of Pediatrics Chongqing, Chongqing 400014, China,Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China,
Correspondence: Dr. L Jiang () or Dr. SD Wu ()
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Chen P, Yang Z, Chen N, Liu L, Su J, Sun M, Li S. Diagnosis and treatment of cryptorchid testicular torsion in children: A 12-year retrospective study. Front Pediatr 2022; 10:968997. [PMID: 36071885 PMCID: PMC9441697 DOI: 10.3389/fped.2022.968997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/01/2022] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To investigate the clinical characteristics, treatment, and prognosis of cryptorchid testicular torsion in children. METHODS The clinical data of 25 children who received treatment for cryptorchid testicular torsion between January 2010 and December 2021 were retrospectively reviewed. The median age of the patients was 64.5 months (range: 2 months to 15 years). All patients had unilateral torsion, and the duration of symptoms ranged from 3 to 192 h. RESULTS Among the 25 patients, five underwent orchidopexy, while the remaining 20 underwent orchiectomy. After 6 months to 8 years of follow up, the 20 patients who had undergone orchiectomy had a well-developed testis on the healthy side. Four of the five patients who had undergone orchidopexy of the affected testis had well-developed testes bilaterally, while one experienced testicular atrophy. CONCLUSION Cryptorchid testicular torsion is a rare urological emergency that displays a delayed presentation and is often misdiagnosed. Clinicians need to carefully review the patient's medical history and ultrasound findings and perform a thorough physical examination to make a correct diagnosis. Active testicular exploration is required for patients suspected to have cryptorchid testicular torsion, and the decision to perform orchidopexy or orchiectomy depends on the intraoperative situation.
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Affiliation(s)
- Pengyu Chen
- Department of Urology, Shenzhen Children's Hospital, China Medical University, Shenzhen, China
| | - Zhilin Yang
- Department of Urology, Shenzhen Children's Hospital, Shenzhen, China
| | - Nana Chen
- Department of Urology, Shenzhen Children's Hospital, China Medical University, Shenzhen, China
| | - Lei Liu
- Department of Urology, Shenzhen Children's Hospital, China Medical University, Shenzhen, China
| | - Jiahong Su
- Department of Urology, Shenzhen Children's Hospital, Shenzhen, China
| | - Mengkui Sun
- Department of Urology, Shenzhen Children's Hospital, Shenzhen, China
| | - Shoulin Li
- Department of Urology, Shenzhen Children's Hospital, Shenzhen, China
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