Detorsion Plus Tunica Vaginalis Flap Coverage in the Management of Ischemic Testis Following Torsion: Experience in Dhaka Shishu (Children) Hospital

2020 ◽  
Vol 35 (2) ◽  
pp. 141-144
Author(s):  
Md Ayub Ali ◽  
Md Hasanuzzaman ◽  
Paritosh Kumar Palit
Keyword(s):  
Categorical Data ◽  
Testicular Torsion ◽  
Tunica Albuginea ◽  
Psychological Trauma ◽  
Testicular Atrophy ◽  
Tunica Vaginalis ◽  
Statistical Software ◽  
Flap Coverage ◽  
Hormonal Dysfunction ◽  
Salvage Rate

Background: Testicular torsion leads to devastating consequences in young boys, about 42% undergo an Orchiectomy resulting in reduced fertility, testicular hormonal dysfunction and psychological trauma. Objective: The aim was to evaluate the testicular salvage rate after detorsion plus tunica albuginea incision with tunica vaginalis flap coverage with orchiopexy. Methods: This was an observational study conducted from January 2016 to December 2017. Data were collected from operation theater and surgery ward register. Data were analyzed using SPSS version 20 statistical software. Continuous data were presented as mean ± SD and categorical data were presented as percentage. Results: Total numbers of patients were 15. Most of the patients presented after 24 hours. Rate of atrophy of testis after orchiopexy was higher in patients presented after 24 hours. Only 4 patients had recognizable testicular atrophy. Surgical site infection was not present in this study. Conclusion: Tunica albuginea incision with tunica vaginalis flap coverage after detorsion with orchiopexy provides more salvage rate in the management of ischemic testis following torsion. DS (Child) H J 2019; 35(2) : 141-144

Incidence of Low-Grade Testicular Injury in Orchidectomy Specimens Post-testicular Torsion

2017 ◽  
Vol 28 (05) ◽  
pp. 433-438
Author(s):  
Piotr Hajduk ◽  
Deirdre Devaney ◽  
Feargal Quinn ◽  
Sami Awadalla ◽  
Olugbenga Aworanti
Keyword(s):  
Animal Studies ◽  
Testicular Torsion ◽  
Tunica Albuginea ◽  
Endocrine Function ◽  
Testicular Atrophy ◽  
Symptom Duration ◽  
Low Grade ◽  
Testicular Injury ◽  
Age Range ◽  
Restitutio Ad Integrum

Introduction Following detorsion and orchidopexy for testicular torsion, predominantly animal studies have reported a risk of autoimmune and reperfusion injury to the contralateral testis. As a result, when testicular viability is compromised, orchidectomy is readily performed. This practice increases the likelihood of testes with potentially reversible injury being excised. We aim to determine the incidence of such occurrences and review the available evidence for and against early orchidectomy when testicular viability is doubtful. Materials and Methods Data for a 15-year period from two pediatric institutions on testicular torsion in children younger than 16 years were reviewed. Using a previously published grading system, the orchidectomy specimens in this cohort with early low-grade injury were analyzed. Low-grade injury suggests the possibility of restitutio ad integrum implying restoration of exocrine and endocrine function of the affected testes. Results Between both institutions, 222 scrotal explorations were performed for testicular torsion; 20 neonatal and 202 outside the neonatal period (age range [median]: 1–28 days [3 days] and 3 months–16 years [13 years], respectively). Of these scrotal explorations, 17 neonatal and 66 nonneonatal orchidectomies were required (85 vs. 33%, respectively; p < 0.0001). From these orchidectomy specimens, 5 (6%) were found to have low-grade injury. The ages of these five children ranged from 9 to 16 years (median 15, mean 13.6 years). Their symptom duration ranged from 8 to 37 hours (median 14, mean 18 hours) and two of these children had a preoperative ultrasound documenting no flow to the testis. Conclusion The finding of histopathological features that may represent salvageability of a torted testis occurs relatively rarely. Because of this possibility, appropriate intraoperative steps to check for reperfusion must be undertaken prior to orchidectomy. More evidence for the use of antioxidants and tunica albuginea decompression to improve testes salvage rates is required. The potential for exocrine and endocrine function if partial testicular atrophy occurs and the evidence for contralateral autoimmune testicular damage in pre- and postpubertal males require further investigation.

Is there bacterial growth inside the tunica vaginalis cavity in patients with unsalvageable testicular torsion?

2021 ◽  
Vol 79 ◽  
pp. S1616
Author(s):  
D.S. Hampl ◽  
F.J.B. Sampaio ◽  
L. Koifmann ◽  
L.A. Favorito
Keyword(s):  
Bacterial Growth ◽  
Testicular Torsion ◽  
Tunica Vaginalis
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