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[Complications of the acute scrotum syndrome in children]
I S Shormanov1,2, D N Shedrov1,2, E V Morozov1,2
1FGBOU VO Yaroslavl state medical university of the Ministry of Health of the Russian Federation, Yaroslavl, Russia.
Insights
Complications from acute scrotal pathology often require repeat surgeries, especially testicular necrosis from preserving organs without objective data. Preventive measures can significantly reduce these adverse events in pediatric patients.
Area of Science:
- Pediatric Surgery
- Urology
Background:
- Acute scrotal pathology in children presents significant management challenges.
- Complications and the need for repeat surgical procedures are common concerns.
Purpose of the Study:
- To identify the causes of complications and repeat surgeries in pediatric patients with acute scrotal pathology.
- To analyze short- and long-term follow-up outcomes.
Main Methods:
- Retrospective analysis of treatment results for 3315 pediatric patients (0-18 years).
- Evaluation of various forms of acute scrotal pathology.
Main Results:
- 43 complications occurred, with 32 requiring surgical intervention.
- Testicular necrosis due to misjudging viability after torsion was the most frequent complication leading to repeat surgery.
- Purulent complications were common in acute epididymitis, linked to disease duration and secondary inflammation.
Conclusions:
- Most complications (88.4%) occurred in the early postoperative period.
- Preventive strategies are crucial for avoiding complications.
- Early diagnosis and appropriate surgical judgment are key to improving outcomes.
Aim:
To establish causes of complications and repeated surgical procedures in patients with acute scrotal pathology during the short- and long-term follow-up.
Materials And Methods:
The treatment results of 3315 patients aged 0 to 18 years with various forms of acute scrotal pathology were analyzed.
Results:
A total of 43 complications were documented, 32 of them required surgical intervention. The most common complication is testicular necrosis due to incorrect judgement of viability after torsion with performing an organ-preserving procedure, which is dictated by the surgeons desire to preserve a testicle. Such a decision is made without objective data and in all cases leads to repeated procedure due to testicular necrosis. Inappropriate surgical hemostasis is often associated with improper surgical technique and underestimation of inflammatory tissue changes. Purulent complications are the most common in acute epididymitis and are caused by the presence of an inflammatory focus in the scrotum. Wide revision of the scrotum in case of testicular appendages pathology is not justified, since the second appendage is rarely found, while the invasiveness of the procedure increases.
Conclusion:
Complications were more common in the early postoperative period (88.4%). Purulent complications are directly dependent on the duration of the disease and are exacerbated by the secondary inflammatory process. Most of complications are treatable; performing of preventive measures helps to avoid them.
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