Low-Grade Injury following Testicular Torsion: A Multicenter Study Confirming a Disturbing Possibility
Makaleler > Tam Makale · 2023
Yazarlar: EMİNE BURCU ÇIĞŞAR KUZU, Sibel TİRYAKİ BİROL, NESLIHAN GUNEY, KAMER POLATDEMİR, YASEMİN ÇAKIR, AHSEN KARAGÖZLÜ AKGÜL, MUHAMMED HASAN TOPER, GÜNGÖR KARAGÜZEL, MURAT UÇAR, CUMHUR İBRAHİM BAŞSORGUN, ŞEYHMUS KEREM ÖZEL, SIDIKA ŞEYMA ÖZKANLI, GÜL ŞALCI, SEVDEGÜL AYDIN MUNGAN, MEHMET UĞUR YILMAZ, BERNA AYTAÇ VURUŞKAN, İSMAİL YAĞMUR, EMİNE ZEYNEP TARİNİ, MELTEM KABA, CANAN TANIK, FURKAN ADEM CANBAZ, ÖZGE HÜRDOĞAN, İDİL RANA USER, DİCLEHAN ORHAN, AHMET ATICI, DİDAR GÜRSOY KUZULUK, EMİN AYDIN YAĞMURLU, DUYGU ENNELİ, ŞEREF SELÇUK KILIÇ, ŞEYDA ERDOĞAN
Urologia Internationalis, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Wos, 2023, cilt 107, ss 971-976
DOI: 10.1159/000534454
Özet
INTRODUCTION: There is an ongoing debate whether to perform orchiectomy or orchidopexy following testicular torsion (TT) in cases where the testis seems non-viable. The main problem is lack of objective criteria defining testicular viability. The aim of this study was to investigate the grade of injury in orchiectomy specimens obtained from cases of TT and its association with clinical findings. METHODS: This multicenter retrospective study involved double-blinded reassessment of the patient files and the pathological specimens using Mikuz classification to analyze the relation between clinical and pathological findings. RESULTS: A total of 289 patient charts from 14 centers were reviewed and 228 were included in this study. Twenty (8.8%) patients had grade 1 injury which refers to reversible injury. The clinical findings of these 20 patients were compared to 208 patients with higher grades of injury. As expected, there was statistically significant difference regarding duration of symptoms (p < 0.001); however, range was wide in both groups (as long as 96 h for grade 1 and as short as 7 h for higher grades). There was no statistically significant difference in any other variable including age (median 14 for both, p = 0.531), symptoms (pain: 19/20 vs. 189/202, p = 0.801; swelling: 13/19 vs. 168/197, p = 0.094), absence of blood flow in Doppler US (15/19 vs. 164/197, p = 0.635), or degree of torsion (median 720° for both, p = 0.172). CONCLUSION: Our study revealed necessity for better criteria to define viability of testis following TT. Histopathological injury appeared to be reversible even in some patients with more severe perioperative findings, late admission, or high degree of twisting. Our findings support the tendency for testicular fixation instead of orchiectomy as none of the clinical or perioperative findings could be attributed to high-grade injury.