治療睪丸扭轉的單一醫學中心經驗報告
許自翔1、黃逸修1,2,3、張延驊1,2,3、黃志賢1,2,3、鍾孝仁1,2,3、吳宏豪1,2,3、林子平1,2,3、林志杰1,2,3、范玉華1,2,3、魏子鈞1,2,3、林登龍1,2,3、陳光國1,2,3
1臺北榮民總醫院 泌尿部
2國立陽明大學 醫學院 泌尿學科；3書田泌尿科學研究中心
The eXPERIENCE OF TReATMENT OF TESTICULAR TORSION IN A SINGLE ACADEMIC CENTER
Tzu-Hsiang Hsu1, Eric Yi-Hsiu Huang1,2,3, Yen-Hwa Chang1,2,3, William J.S. Huang1,2,3, Hsiao-Jen Chung1,2,3, Howard H.H Wu1,2,3, Tzu-Ping Lin1,2,3, Chi-Cheh Lin1,2,3, Y.H. Fan1,2,3, Zi-jun Wei1,2,3, Alex T.L. Lin1,2,3, Kuang-Kuo Chen1,2,3
1Department of Urology, Taipei Veterans General Hospital, Taipei, Taiwan
2Department of Urology, School of Medicine, and 3Shu-Tien Urological Science Research Center, National Yang-Ming University
Purpose: Testicular torsion is a urologic emergency and delayed diagnosis and management could result in testicular death. This study aimed to describe the symptoms, epidemiology and treatment in patients with testicular torsion at our hospital.
Materials and Methods: From January, 2000 to February, 2016, patients diagnosed as testicular torsion in our institute were enrolled. The demographic data, clinical presentation, pre-operative diagnosis e.g. scrotal ultrasound finding and surgical findings were investigated.
Results: Fifty-one patients were identified, mean age was 20.8 ± 16.1 years (range 0-86 years). The distribution of testicular torsion in each season were 15.6% (spring), 15.6% (summer), 17.6% (autumn) and 51% (winter). Forty seven patients (92.2%) presented to hospital with symptom of scrotal pain. The laterality was 30 (58.8%) in left, 17 (33.3%) in right, and 3 (5.9%) in bilateral testicles. Thirty-nine cases received color Doppler scrotal ultrasound for diagnosis, demonstrated decreased testicular blood flow in 11 cases and no testicular blood flow in 13 cases. Among 51 patients, 14 cases received orchiectomy, 1 received partial orchiectomy, 27 cases received orchiopexy and 4 patients did not undergo surgery. The salvage rate of testis in patients with testicular torsion was 72.5% and contralateral orchiopexy was performed in 33 cases (70%).
Conclusions: In our experience, almost half of the cases occurred in winter. Doppler ultrasound was critical in the diagnosis of testicular torsion. The salvage rate was high if immediate surgery offered.