The Section of Urology of the American Academy of Pediatrics met for three days in conjunction with the 53rd annual meeting of the Academy in Chicago. Papers and panel discussions that would be of interest to the pediatrician are summarized herein according to topic. As there has been an increasing number of basic research papers presented in recent years, the Section, this year, initiated a prize for basic research. Also new to the meeting was the awarding of the first annual Pediatric Urology Medal, which was given to Harry Spence for contributions made to the field.
TESTICULAR TORSION
Recent reports of unilateral testicular torsion have suggested that adverse effects may occur to the contralateral testicle, if the ischemic testicle is treated by surgical detorsion and left in place rather than removed.1-4 Three authors addressed this problem by investigating animal models.
Animal Models
In prepubertal rats undergoing experimentally produced testicular torsion, Rabinowitz and associates found histologic changes in the contralateral testicle. The changes in the contralateral testicle were dependent upon the duration of torsion and were significantly greater when the ischemic testicle was detorsed and left in place. The degree of histologic changes in the ischemic testicle, especially the degree of germ cell damage, was the best prediction of long-term damage to the contralateral testicle. In the animal model, these changes could be averted by removing the ischemic testicle. Although not going as far to recommend orchiectomy as the treatment of choice for all cases of torsion, Dr. Rabinowitz did suggest that a testicular biopsy in prepubertal boys with testicular torsion may be a reliable index to subsequent long-term contralateral damage if the ischemic testicle is detorsed and pexed rather than removed.