Torsion of the Testis

Abstract

22 cases operated on for testicular torsion at Gentofte Hospital Surgical Department H are reported.

The material is devided into two maingroups, i.e. 11 cases in whom the testes seemed to be saved by the operation and 11 cases in whom hemicastration had to be done. In the first group the admission diagnosis was usually correct and treatment was effectuated within few hours after the arrival in the hospital. In the second group all but one admission diagnoses were wrong, acute epididymitis being the most usual diagnosis, and the patients were erroneously treated with antibiotics for some time before admission. In this group, however, 3 patients were admitted to the hospital promptly after onset of symptoms, the conditions were misdiagnosed by the surgeons, and the testes were lost.

The age distribution in torsion of the testis is characteristic, more than 8 out of 10 patients being between 10 and 20 years old. The symptomatology and differential diagnostic possibilities are discussed, and it is concluded that explorative surgery should be promptly applied when a diagnosis of acute scrotal swelling is uncertain, especially in the younger group of patients. Profylactic fixation of the opposite testis is advisable.