Title: A Retrospective Study of Incidence of Torsion Testes in Acute Scrotum

Authors: Dr K.Ravichandran, Dr R.Ramesh, Dr M.V. Pradeep Anand, Dr V.Uvaraj

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i1.90

Abstract

Aim: The main aim of this study is to note the prevalence and epidemiology of acute scrotum, their presentation, to find out the incidence of torsion testes in patients who presented with acute scrotum there by facilitating an approach in identifying those patients who need early intervention to decrease associated morbidity and mortality.

Objectives: To find out the 1.Various causes of acute scrotum, 2.Age distribution, 3.Pre disposing factors, 4.Presenting symptoms, 5.Incidence of torsion testes, 6.Management, 7.Iintra –operative findings ,8.post operative study , 9.morbidity and 10.mortality.and the outcome in patients who presented with acute scrotum in Rajah Muthiah Medical College Hospital.

Materials and Methods: The study was conducted by a retrospective analysis of the patients who were admitted with acute scrotum, in all the surgical units of the Department of General Surgery, in Rajah Muthiah Medical college and hospital between May 2015 and October 2017. To study 1.various causes of acute scrotum. 2. To know the mode of presentation, investigations required and the treatment outcome of various causes of acute scrotum with special reference to torsion of testis.

Keywords: Scrotum, Testes, orchitis, epidydimis, Torsion, USG, Doppler.

References

  1. Mansbach JM, Forbes P, Peters C. Testicular torsion and risk factors for orchiectomy. Arch Pediatr Adolesc Med. 2005;159(12):1167–1171. [PubMed]
  2. Scrotal pain may point to testicular torsion. 2008 Available from: < http://www.cmpa-acpm.ca/cmpapd04/docs/resource_files/infoletters/2006/com_il0630_2-e.cfm>, 2008.
  3. Favorito LA, Cavalcante AG, Costa WS. Anatomic aspects of epididymis and tunica vaginalis in patients with testicular torsion. Int Braz J Urol. 2004;30(5):420–424. [PubMed]
  4. Cuckow PM, Frank JD. Torsion of the testis. BJU Int. 2000;86(3):349–353. [PubMed]
  5. Casey JT, et al. Cold weather causing testicular torsion is an urban legend; Moderated poster at AUA Annual Meeting; 2011.
  6. Cost NG, et al. Pediatric testicular torsion: demographics of national orchiopexy versus orchiectomy rates. J Urol.  2011;185(6 Suppl):2459–2463. [PubMed]
  7. Gorbonos A, Cheng EY. Perinatal testicular torsion in siblings. J Pediatr Urol. 2007;3(6):514–515.[PubMed]
  8. Okeke LI, Ikuerowo OS. Familial torsion of the testis. Int Urol Nephrol. 2006;38(3–4):641–642.[PubMed]
  9. Castilla EE, et al. Neonatal testicular torsion in two brothers. J Med Genet. 1975;12(1):112–10.[PMC free article] [PubMed]
  10. Sozubir S, et al. Loss of Insl3: a potential predisposing factor for testicular torsion. J Urol. 2010;183(6):2373–2379. [PubMed]
  11. Wang Y, et al. Screening For A Genetic Basis For Testicular Torsion: The Insulin-3 (Insl3) And Lgr8 Genes. J Urol. 2008;179(4):147. (Abstract #413).
  12. Kaye JD, et al. Parenchymal echo texture predicts testicular salvage after torsion: potential impact on the need for emergent exploration. J Urol. 2008;180(4 Suppl):1733–1736. [PubMed]
  13. Kalfa N, et al. Ultrasonography of the spermatic cord in children with testicular torsion: impact on the surgical strategy. J Urol. 2004;172(4 Pt 2):1692–1695.  discussion 1695. [PubMed]
  14. Vijayaraghavan SB. Sonographic differe-ntial diagnosis of acute scrotum: real-time whirlpool sign, a key sign of torsion. J Ultrasound Med. 2006;25(5):563–574. [PubMed]
  15. Kutikov A, et al. Testicular compartment syndrome: a new approach to conceptual-lizing and managing testicular torsion.  Urology. 2008;72(4):786–789. [PubMed]
  16. Timing and surgical management of neonatal testicular torsions.[J Pediatr Surg. 2010]
  17. Outcomes of scrotal exploration for acute scrotal pain suspicious of testicular torsion: a consecutive case series of 173 patients.[BJU Int. 2011]
  18. Incidence of the bell-clapper deformity in an autopsy series.[Urology. 1994]
  19. Anatomic aspects of epididymis and tunica vaginalis in patients with testicular torsion.[Int Braz J Urol. 2004]
  20. Perinatal testicular torsion in siblings.[J Pediatr Urol. 2007]
  21. Familial testicular torsion in three consecutive generations of first-degree relatives.[J Pediatr Urol. 2011]
  22. Parenchymal echo texture predicts testicular salvage after torsion: potential impact on the need for emergent exploration.[J Urol. 2008]
  23. Ultrasonography of the spermatic cord in children with testicular torsion: impact on the surgical strategy.[J Urol. 2004]
  24. Multicenter assessment of ultrasound of the spermatic cord in children with acute scrotum.[J Urol. 2007]
  25. Sonographic differential diagnosis of acute scrotum: real-time whirlpool sign, a key sign of torsion.[J Ultrasound Med. 2006]
  26. Management of neonatal testicular torsion: Which way to turn?[Can Urol Assoc J. 2008]
  27. Management of perinatal torsion: today, tomorrow or never?[J Urol. 2005]
  28. Neonatal bilateral testicular torsion: a plea for emergency exploration.[J Urol. 2007]
  29. Review Salvage of bilateral asynchronous perinatal testicular torsion.[J Urol. 2011]
  30. Testicular torsion and risk factors for orchiectomy.[Arch Pediatr Adolesc Med. 2005]

Corresponding Author

Dr K.Ravichandran

Associate Professor of Surgery, Dept of Surgery Rajah Muthiah Medical College,

Annamalai University, Annamalainagar, Chidambaram, Tamil Nadu