Clinical Analysis And Long-term Follow-up Study Of Unilateral Testicular Torsion In Children

Objective: To summarize the clinical characteristics of unilateral testicular torsion in children,and follow up the secondary sex characteristic and fertility status of them.Methods: The clinical data of children with unilateral testicular torsion affiliated to the Children’s Hospital of Chongqing Medical University from January 2002 to December 2016 were collected.We analysed the clinical characteristics of the patients over 18 years old and a twist scoring system designed by Barbosa was performed on them.Then the secondary sex characteristic and fertility circumstance were followed up.Results: 63 cases of unilateral testicular torsion were studied,including 28 cases with orchiopexy and 35 cases with orchiectomy.The youngest age was 6 years and 9 months,and the maximum age was 17 years and 10 months when suffering,13 years and 8months on average.Retrospective validation showed 30.0% of patients at high and 11.7% at low risk.There were 47 cases followed up and 16 lost among the 63 patients,in which secondary sex characteristic of 44 cases with little abnormality.16 patients intended to conceive for more than one year.The unpregnancy rate was 22.2% and 14.3% in orchiopexy and orchiectomy group,respectively(P=1.0).The mean time to pregnancy in these groups was 8.6±5.1 months and 7.5±3.6 months,respectively(P=0.653).Conclusion: Early diagnosis and surgical exploration after testicular torsion are crucial.The Barbosa Twist Scoring System is not recommended in clinical application because of its uncertain efficiency for the time being.In children suffered unilateral testicular torsion,the secondary sex characteristic later seem not to be involved.The fertility may be affected,but there is no significant difference in effects on fertility between removal and retention of the testis.The operational pattern should be determined according to the results of intraoperative exploration.