Diagnosis And Treatment Of 92 Cases Of Testicular Torsion And Analysis Of Family Anxiety

BackgroundAs an important endocrine organ and sexual organ for men,the testis plays an extremely important role in the growth and development of boys.In clinical work,children may lose their testicles due to testicular tumors,testicular torsion,congenital testicular dysplasia,testicular trauma,and hermaphroditism.For children,testicular torsion is one of the main causes of testicular loss.Testicular torsion refers to the torsion of the testis and spermatic cord on the basis of congenital anatomical abnormalities or increased testicular mobility,resulting in testicular damage or necrosis caused by insufficient blood supply to the testis and epididymis.Testicular torsion is a common scrotal emergency in pediatric urology.It can occur at any age,but infancy and peripuberty are the two peak periods of its onset.Studies have shown that the incidence of testicular torsion in people under 25 years of age is 1/4 000.Once the testicular torsion is misdiagnosed or delayed,it may lead to necrosis of the testis.According to statistics,the cumulative loss of testis is 31.9 to 41.9%[1].As an important sign for men,the testis is extremely important in the process of gender identification[2],and its loss will have a great impact on the psychology and physiology of children[3].In the field of clinical surgery,the successful completion of the operation seems to mean the end of the treatment.However,as people pay more attention to their external image and increase social attention,this type of testicular torsion necrosis or reduction after atrophy occurs.Children and their families are increasingly aware of the physical and psychological effects of testicular loss,which prompts our doctors to detect early and take targeted treatment measures to improve the quality of life of children and their families[4].Psychological stress is the physiological,psychological and behavioral response of the body after being subjected to external threats or harmful stimuli,and it is a state of stressful response to adapt to the environment.According to the psychological stress theory,the children and their family members will have corresponding psychological reactions during the postoperative recovery period,which will then affect the children’s psychological and physical health[5].In family life,the psychological behaviors of family members influence each other,and parents’ anxiety and concern about prognosis are important factors that affect the mental health of children[6].Searching the literature found that domestic research on testicular torsion in children mainly focused on the diagnosis of testicular torsion,misdiagnosis,risk factors for testicular necrosis,special types of testicular torsion,etc.There is very little research on the psychological changes of children and their families after surgery.After consulting foreign literature,it is found that in addition to the above-mentioned studies on testicular torsion,foreigners have also studied the physiology and psychology of postoperative children.They believe that orchiectomy will have a negative impact on the psychology of children and their families.They proposed and applied testicular pseudo-remodeling to reshape the appearance of the scrotum to relieve the psychological pressure of children and their families[7-10].At present,there is no testicular prosthesis implantation in children in my country,And there is no need for research on testicular prosthesis in children.ObjectiveThis study conducted a retrospective analysis the clinical characteristics of testicular torsion,the operation process and the postoperative self-esteem and family anxiety of children after torsion,and analyze the related influencing factors of family anxiety,so as to increase the attention to testicular torsion and the psychological changes of family members,for clinical diagnosis and treatment.Provide a basis for the development of psychological intervention plans.MethodsThis study selected the clinical case data of 92 children with testicular torsion admitted to the First Affiliated Hospital of Zhengzhou University from January 2016 to December 2019,and compared the ages of the children with two surgical outcomes(resection group,retention group).Clinical manifestations,type of disease,duration of symptoms,type of testicular torsion,degree of torsion,testicular vitality,etc.The postoperative follow-up was 6 months to 3 years.The content of the follow-up included ultrasound and sex hormones.Using Rosenberg psychological self-esteem scale(children),Zung’s anxiety self-rating scale(family members)and self-compiled general questionnaires to analyze the psychological changes of testicular torsion on the children and their families,and to analyze the factors affecting family anxiety.Use SPSS22.0 data package to perform statistical analysis on related data.Results1.Among 92 cases,80 were on the left side and 12 were on the right side;the youngest was 10 hours,the oldest was 15 years old,and the median age was 5 years;the first diagnosis was misdiagnosed as appendicitis in 3 cases,inguinal incarcerated hernia in 1 case,orchitis or epididymitis 16 Among the cases,1 case was iatrogenic,7 cases of neonatal testicular torsion,7 cases of cryptorchidism with testicular torsion,and 6 cases of history of scrotal trauma.The rest were delayed visits.2.78 cases of testicular necrosis resection,14 cases of testicular reduction and fixation;86 cases of intrathecal torsion and 6 cases of extrathecal torsion;postoperative sex hormone levels were within the normal range.Ultrasound showed that 8 cases of affected side testicular atrophy in varying degrees,healthy There was no atrophy on the sides.3.Children’s self-esteem is significantly negatively correlated with family anxiety.The heavier the self-esteem impairment of children,the higher the family anxiety.Testicular necrosis is statistically significant for children’s self-esteem and family anxiety,and testicular preservation is statistically significant for family anxiety.4.The results of a one-way analysis of variance of general data on family anxiety showed that:the children’s age,parents’.age,and family monthly income have statistically significant differences in parents’ anxiety(P<0.05),and family address and number of children have differences in parents’ anxiety No statistical significance.5.Multivariate linear logistic regression analysis showed that testicular vitality and children’s age were independent risk factors for family anxiety.6.As children age,the willingness of prosthesis transplantation increases,and the demand for transplantation becomes stronger.Conclusion1.Early diagnosis and treatment of testicular torsion is very important to save testicular vitality.Delayed visits and misdiagnosis in the first diagnosis are the main causes of loss of testicular vitality.It is necessary to strengthen the popularization of knowledge education for children and their families,and improve the ability of first-visiting doctors to identify the disease.2.Testicular torsion can lead to increased anxiety in family members.The vitality of the testis and the age of the child are factors that affect anxiety.Targeted prevention and intervention should be taken to improve the psychological state of the family members of the child.3.The degree of family anxiety is negatively correlated with the self-esteem status of children,and increasing the self-esteem value of children can reduce family anxiety.