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Testicular torsion in the inguinal canal in children

Zenon Pogorelić1, Ivana Mrklić, Ivo Jurić

  • 1Department of Pediatric Surgery, Split University Hospital Centre and Split University School of Medicine, Spinčićeva 1, 21 000 Split, Croatia.

Journal of Pediatric Urology
|November 6, 2012
PubMed

Insights

Torsion of an undescended testis in children is rare but requires prompt treatment. Early diagnosis and intervention improve testicular preservation rates, with most cases successfully treated via orchidopexy.

Area of Science:

  • Pediatric Surgery
  • Urology
  • Andrology

Background:

  • Undescended testes (cryptorchidism) are associated with an increased risk of torsion.
  • Torsion of an undescended testis is a surgical emergency requiring prompt diagnosis and management.
  • Early recognition is crucial to prevent testicular necrosis and preserve function.

Purpose of the Study:

  • To evaluate the management strategies and clinical outcomes for pediatric patients experiencing torsion of an undescended testis.
  • To analyze the factors influencing testicular salvage versus orchidectomy in these cases.

Main Methods:

  • Retrospective review of 84 pediatric patients who underwent surgery for testicular torsion.
  • Analysis of medical records including history, physical examination, operative findings, and follow-up data.
  • Clinical diagnosis confirmed by Doppler ultrasound and inguinal canal exploration.

Main Results:

  • Eight children presented with torsion of an undescended testis.
  • Four patients underwent successful orchidopexy (testicular preservation) with a mean symptom duration of 6 hours.
  • Four patients required orchidectomy due to testicular gangrene, with a mean symptom duration of 50 hours.
  • Testicular atrophy occurred in only one patient at follow-up.

Conclusions:

  • Torsion of an undescended testis is a rare but significant condition necessitating urgent diagnosis and treatment.
  • Prompt surgical intervention, ideally within 6 hours of symptom onset, significantly increases the likelihood of testicular salvage.
  • Improved clinical awareness and timely referral by primary care physicians are vital for preventing this condition and its adverse outcomes.
Abstract

Keywords:
ChildrenCryptorchidismInguinal canalSpermatic cord torsionTesticular torsionUndescended testis

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