Predictors of Spermatic Cord Torsion—Clinical Presentation and Intraoperative Findings

Axel Hegele, Dirk Wappelhorst, Zoltan Varga, Fabian Brüning, Peter Olbert, Carsten Frohme, Rainer Hofmann

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DOI: 10.4236/oju.2011.14017                

Abstract

Background: To evaluate aetiology of acute scrotum after surgical exploration suspicious for spermatic cord torsion, to compare surgical with clinical findings and to support the clinician distinguishing spermatic cord torsion from other diseases mimicking this emergency requiring surgical exploration. Methods: All men with the diagnosis of an acute scrotum who underwent emergency scrotal exploration between January 1995 and October 2009 were retrospectively evaluated. Results: 230 patients were analyzed. Torsion of the spermatic cord (53%) was the most common cause followed by torsion of the testis appendages (25%). Patients with spermatic cord torsion were significantly older (15.5 y) and haunted hospital faster than others (p < 0.001). Statistical analysis revealed that high testicular position and reduced/missing blood flow using duplex sonography are associated with increased probability of spermatic cord torsion. A significant difference in seasonal variation was not seen.Conclusions: Our data demonstrate that spermatic cord torsion is more common in adolescent. Short pain duration and high intrascrotal position of the testicle are associated with higher probability of spermatic cord torsion. Duplex sonography plays an important role in the diagnostic workup but history and physical examination are the crucial parameters. In nebulous clinical cases emergency surgical exploration has to be recommended.

Keywords

Acute Scrotum, Spermatic Cord Torsion, Emergency, Clinical Predictor

Conflicts of Interest

The authors declare no conflicts of interest.

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