Document Detail


Salvage of bilateral asynchronous perinatal testicular torsion.
MedLine Citation:
PMID:  21555015     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
PURPOSE: Current management strategies for prenatal torsion include observation alone, delayed contralateral orchiopexy and emergent contralateral orchiopexy. Bilateral torsion is now being reported with more frequency and approximately a third of these patients have asynchronous torsion. We highlight the role of scrotal exploration in neonates diagnosed with bilateral asynchronous testicular torsion.
MATERIALS AND METHODS: We reviewed the clinical experience from 2000 to present of 2 senior pediatric urologists to identify cases of bilateral perinatal testicular torsion. Asynchronous torsion was identified by the varying physical findings of each testicle at exploration. A literature review was done to evaluate the evolving management of perinatal testicular torsion.
RESULTS: Six cases of bilateral perinatal torsion were identified since 2000. In 3 of the 6 cases extravaginal torsion of the contralateral testis was incidentally identified at surgical exploration. All 3 testes had normal Doppler flow before exploration. Testicular salvage was not successful in the 2 patients with bilaterally absent blood flow on newborn ultrasound. The 3 cases of incidentally diagnosed contralateral torsion and 1 of preoperatively diagnosed contralateral torsion were successfully salvaged. Thus, 4 of 6 patients with bilateral torsion were left with 1 viable testis.
CONCLUSIONS: Physical examination findings and radiography can be inaccurate to assess the contralateral testis in males born with prenatal torsion. We have adopted the strategy of emergent surgical exploration in cases of prenatal torsion. Using this approach anorchia was minimized in patients with bilateral asynchronous torsion.
Authors:
Christopher C Roth; Gerald C Mingin; Joseph Ortenberg
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Publication Detail:
Type:  Journal Article     Date:  2011-04-28
Journal Detail:
Title:  The Journal of urology     Volume:  185     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2464-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
University of Vermont College of Medicine (GCM), Burlington, VT, USA. croth@lsuhsc.edu
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Comment In:
J Urol. 2011 Jun;185(6 Suppl):2468   [PMID:  21555016 ]

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