Ocena ryzyka oraz możliwości przewidzenia amputacji gonady w przypadku skrętu jądra u dzieci

Michał Błaszczyński¹, *Jakub Noskiewicz², Agata Peikow², Katarzyna Szczęsna²

Summary
Introduction. Testicular torsion is presenting as an acute pain in the testicle, redness and swelling of the scrotum. Immediate surgical exploration of the inguinal canal (duration of symptoms up to surgical exploration less than 4-6 h) gives the opportunity to save the gonad from necrosis.
Aim. The evaluation of risk factors and possibility of prediction of orchiectomy for testicular torsion in children.
Material and methods. A retrospective analysis of case records of 97 patients with testicular torsion hospitalized in the years 2001-2011 in the Department of Pediatric Surgery, Traumatology and Urology PUMS.
Results. Testicular torsion occured most frequently in patients between 13 and 18 years and in infants. Risk of amputation in these groups was equal: 57.0%, 72.0%. General risk of orchiectomy for testicular torsion in children reached 56.7%. Only reduction of blood flow observed during Power Doppler examination can differentiate two groups: with and without necessity of orchiectomy (p = 0.005). This examination was a sensitive marker detecting the risk of testicular necrosis (sensitivity = 64.6%; specificity = 66.7%) in case of testicular torsion. This examination was the most sensitive in patients between 13 and 18 years (81.8%).
Conclusion. Reduction of blood flow observed during Power Doppler examination is a sensitive marker detecting testicular torsion and it correlates with testicular necrosis. This examination cannot delay surgical exploration of the inguinal canal – the most important diagnostic and therapeutic procedure.

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