Clinical Analysis Of Testicular Torsion In Three Hospitals Of Gansu Province (Report Of 128 Cases Attached )

Objective:This study retrospectively analyzed the level of diagnosis and treatment of testicular torsion in Gansu Province,providing recommendations for the diagnosis and treatment of testicular torsion.Method:The clinical data of 128 patients diagnosed with testicular torsion who were admitted to the Second Hospital of Lanzhou University,the General Hospital of Lanzhou Military Command,and the First Hospital of Lanzhou University between December 2007 and October2018 were collected,and were followed up in terms of ultrasound,male hormone,and semen analysis of the male reproductive system.Result:Data were collected from 128 patients.Ages ranged from 7 day to 67 years,7.81%were younger than 6 years,6.2% were 6 years to 11 years,71.8% were 12 years to 20 years,9.3%were 21 years to 30 years,and 4.6% were over 30 years.The first symptom was testicular pain in114 patients,the first symptom was lower abdominal pain in 6 patients,and the first symptom was pain in the inguinal region in 8 patients.The first misdiagnosis rate was 66.4%.Among them,the misdiagnosis rate was 28.0% in the third grade hospital and 75.7% in the non-tertiary hospital.Twenty-five patients were misdiagnosed as orchitis and 20 as epididymitis.No testicular blood flow signal was detected in 89 patients(76.72%).Nine patients(7.75%)had decreased testicular blood flow signals.The testicular blood flow signals were star-like in 9 cases(7.75%).Three patients had increased blood flow signals,and 6 patients had no significant changes in blood flow signals.An independent t-sample test was performed on the size of the affected and unaffected testes after the onset of the disease,resulting in a P value of 0.003,which was statistically different.6 patients treated conservatively,122 patients underwent surgical treatment,8 patients underwent unilateral testicular torsion reduction and fixation;24 patients underwent unilateral testicular torsion reduction and fixation with contralateral orchidopexy;33 patients underwent unilateral orchidectomy;57 patients underwent unilateral orchidectomy with contralateral orchidopexy.The patients whose disease duration was less than 7 days were divided into twogroups: within 12 hours after diagnosis and outside 12 hours after diagnosis.Finally,the P value was 0.000027 less than 0.05,indicating that the longer the diagnosis,the higher the chance of orchiectomy.A total of 59 patients were followed up after discharge,of whom 14 had follow-up testosterone levels,7 had follow-up semen analysis,and 29 had follow-up ultrasound of the male reproductive system.Conclusion:The most commonly used method for diagnosis of testicular torsion is color Doppler ultrasound,and most patients will show decreased or disappeared testicular blood supply.Patients with atypical color Doppler ultrasound should be closely combined with medical history,early surgical exploration,and reduce unnecessary repetitive color Doppler ultrasound examination.The duration of symptoms and the degree of torsion before operation are two important parameters to predict whether the testicle can survive.At short-term follow-up,it was found that the contralateral testis did not twist regardless of whether the contralateral side was fixed or not.