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Long-term follow-up results of testicular torsion in children


1 Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China
2 Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing 400014, China
3 National Clinical Research Center for Child Health and Disorders, Chongqing 400014, China
4 China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China
5 Chongqing Key Laboratory of Pediatrics Chongqing, Chongqing 400014, China
6 Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
7 Department of Pediatric Urology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510620, China
8 Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, China

Correspondence Address:
Li Jiang,
Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042
China
Sheng-De Wu,
Department of Urology, Children's Hospital of Chongqing Medical University, Chongqing 400014; Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering, Chongqing 400014; National Clinical Research Center for Child Health and Disorders, Chongqing 400014; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014; Chongqing Key Laboratory of Pediatrics Chongqing, Chongqing 400014; Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China
China
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aja2021127

PMID: 35259784

A retrospective cohort study was conducted at the Children's Hospital of Chongqing Medical University from November 2004 to December 2020 to investigate the long-term follow-up results after testicular torsion (TT) in children. Boys with TT were divided into the salvage orchiopexy group and the orchiectomy group, and the baseline characteristics, ultrasonographic indications, intraoperative findings, testicular volumes, and adverse events during follow-up were compared. A total of 145 cases were included in this study. Approximately 56.6% of patients who underwent salvage orchiopexy had testicular atrophy (TA), and the median testicular volume loss of the testes was 57.4%. Age less than 6 years, delayed surgery, and intraoperative poor blood supply were associated with TA in pediatric TT after orchiopexy. Most atrophied testes appeared within 3–6 months after surgery. Compared with the corresponding age-matched healthy controls, the contralateral testicular volumes were larger in the orchiopexy (P = 0.001 without TA, and P = 0.042 with TA) and orchiectomy groups (P = 0.033). The adverse events were comparable in patients with orchiectomy or orchiopexy. In summary, follow-up before 3 months after surgery may not offer sufficient clinical value, while that 3 months after surgery should be regarded as the first follow-up time for testicular monitoring. The contralateral testes of patients with TT showed compensatory hypertrophy. We suggest performing orchiectomy when torsed testes are surgically assessed as Arda grade III or inviable.


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