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Torsion of the spermatic cord in adults:a multicenter experience in adults with surgical exploration for acute scrotal pain with suspected testicular torsion

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Asian Journal of Andrology 2022年第6期24卷 575-578页

作者： Van Thi Dang Benjamin Pradere Anne Mauger de Varennes Nadia Ali Benali Maxime Vallee William Berchiche Bastien Gondran-Tellier Gaelle Margue Clement Michiels Charles Gaillard Tristan Grevez Florian Bardet Maud Hulin Anthony Manuguerra Ugo Pinar Caroline Plassais Margeux Felber William Wandoren Kévin Kaulanjan Ines Dominique Marc Sbizerra Emilien Seizilles de Mazancourt Xavier Matillon Igor Duquesne Maxime Chabenes Victor Gallard Lucas Freton Francois Lannes Zine-Eddine Khene Department of Urology Toulouse University HospitalToulouse 31000France Department of Urology Medical University of ViennaVienna 1090Austria Department of Urology Rennes University HospitalRennes 35000France Department of Urology Poitiers University HospitalPoitiers 86000France Department of Urology Marseille North HospitalMarseille 13000France Department of Urology Bordeaux University HospitalBordeaux 33000France Department of Urology Tours University HospitalTours 37000France Department of Urology Dijon University HospitalDijon 21o00France Department of Urology Reims University HospitalReims 5i000France Department of Urology Nancy University HospitalNancy 54000France Department of Urology Hopitaux Universitaires Pitie-SalpetriereAP-HPParis 75013France Department of Urology Pointe a Pitre University HospitalGuadeloupe 97000France Department of Urology Lyon University HospitalLyon 69000France Department of Urology Cochin HospitalAP-HPParis 75000France Department of Urology Grenoble University HospitalGrenoble 38000France Department of Urology Strasbourg University HospitalStrasbourg 67000France

Acute scrotal pain(AsP)requiring surgical exploration is common in the pediatric population,but little has been reported on this subject with regard to the adult population.The aim of this study was to investigate the demographic and clinical characteristics and outcomes of scrotal explorations performed on adult patients.Patients over 21 years of age who underwent surgical exploration for ASP with suspected testicular torsion(TT)at 14 French hospitals between January 2005 and December 2019 were included in this study.The main outcome measures were demographic characteristics,pathology found during scrotal exploration,and perioperative outcomes.Logistic regression was used to perform univariate and multivariate analyses to identify predictors of TT.Data for 1329 men were analyzed.The median age was 30(interquartile range[IQR]:25-35;range:21-89)years.Regarding the clinical examination,867(65.2%)patients presented with an elevation of the testicle,613(46.1%)patients with scrotal edema or erythema,and 211(15.9%)patients with nausea or vomiting.Operative findings identified TT in only 684(51.5%)patients,epididymo-orchitis in 112(8.4%)patients,a tumor in 16(1.2%)patients,and no causes in 475(35.7%)patients.Orchiectomy for nonviable testes was required in 101(7.6%)patients.In multivariate analysis,an elevation of the testicle,erythema/swelling,and the presence of nausea/vomiting were found to be associated with the occurrence of TT.Testicular torsion is not exclusive to children and adolescents,so must be considered in males of any age with acute scrotal findings.However,one-third of scrotal explorations in adults did not lead to a diagnosis.

关键词： adults diagnosis exploration scrotal emergencies spermatic cord torsion ultrasonography

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