睾丸扭转和精索扭转的早期诊断与治疗(附10例报告)

目的探讨睾丸和精索扭转的早期诊断及治疗方法,提高睾丸和精索扭转的诊断和治疗水平.方法回顾性分析10例睾丸精索扭转临床资料诊治经验进行总结.结果7例术前彩超多普勒血流成像(CDFI)应作为诊断疾病的常见与首选检查方法,诊断并经手术证实合格率100%,经手术检查9例手术复位,固定睾丸获救,1例行睾丸切除术,所有病例均行对侧探察固定.结论彩超对睾丸精索扭转的早期诊断有帮助,早期诊断及时治疗是提高疗效的关键,彩超作为诊断疾病的常见和首选方法,对睾丸精索扭转一旦确诊或疑有精索扭转的患者应及早紧急复位,从而挽救睾丸,同时行睾丸固定术也十分必要,对确诊毫无保留价值的睾丸行切除术.     

睾丸扭转和精索扭转的早期诊断与冶疗（附10例报告）

目的:探讨睾丸和精索扭转的早期诊断及治疗方法,提高睾丸和精索扭转的诊断和治疗水平。方法:回顾性分析10例睾丸精索扭转临床资料诊治经验进行总结。结果:7例术前彩超多普勒血流成像(CDFI)应作为诊断疾病的常见与首选检查方法,诊断并经手术证实合格率100%,经手术检查9例手术复位,固定睾丸获救,1例行睾丸切除术,所有病例均行对侧探察固定。结论:彩超对睾丸精索扭转的早期诊断有帮助,早期诊断及时治疗是提高疗效的关键,彩超作为诊断疾病的常见和首选方法,对睾丸精索扭转一旦确诊或疑有精索扭转的患者应及早紧急复位,从而挽救睾丸,同时行睾丸固定术也十分必要,对确诊毫无保留价值的睾丸行切除术。     

睾丸扭转21例分析

目的：提高睾丸扭转的诊治水平。方法：回顾性分析大庆油田总医院21例睾丸扭转患者诊治情况。结果：5例发病10 h以内,2例自行复位,3例手术复位者,术后睾丸均存活;其余16例扭转超过10 h,睾丸已坏死,均行睾丸切除术。结论：彩超对睾丸精索扭转早期诊断有帮助。早期诊断,及时治疗是提高疗效的关键。对睾丸精索扭转确诊或疑有精索扭转的患者应及早行手术探查,以挽救睾丸。对于确诊已保留价值的睾丸需行切除术。     

精索扭转15例临床诊治体会

目的 总结精索扭转外科诊治方法 与预后.方法 对15例预备役战士精索扭转临床资料进行回顾性分析.结果 13例行手术探查,证实为精索扭转.2例经手法复位成功.保留睾丸5例,切除睾丸8例.随访1年,患者精液中精子数量及精子活力均不同程度下降.结论 精索扭转患者应及时行彩色多普勒超声检查,并及早外科手术及复位固定,能提高睾丸存活率.     

睾丸扭转的诊断和治疗(附11例报告)

目的：提高睾丸扭转的诊断和治疗水平。方法：回顾性总结11例睾丸扭转病人的诊治资料，结合文献进行分析。结果：2例经手法复位治愈，2例经手术复位治愈，7例行手术睾丸切除。结论：彩超能反映扭转睾丸的血流变化，对睾丸扭转的早期诊断很有帮助。早期诊断、早期治疗是提高本病疗效的关键。     

睾丸扭转诊断与治疗

目的：提高睾丸扭转的诊断和治疗水平。方法：回顾性分析18例初诊为睾丸扭转临床资料厦相关文献报道，对睾丸扭转的病因、病理厦临床诊断治疗进行探讨。结果：18例经彩色超声多普勒检查16例确诊，1例手术中证实为附睾睾丸炎；15例行睾丸切除术，2例行复位固定术。结论：睾丸扭转是泌尿外科急症，青少年是高发人群，早期行探查手术治疗对提高睾丸的存活率有重要意义。     

精索扭转12例临床分析

目的：总结对精索扭转的诊疗经验。方法：报告12例精索扭转病例的临床诊疗情况。结果：1例自行复位，余均经手术证实为精索扭转，且均属鞘膜内型。5例扭转时间短或是不完全扭转者得以保留睾丸。7例睾丸坏死予以手术切除。结论：对于阴囊急症患者，尤其是青少年，首诊医师应高度警惕精索扭转的可能，彩色多普勒应作为诊断精索扭转的常规和首选检查方法，早期积极手术探查是提高睾丸成活率的关键。     

12例睾丸扭转的诊断与治疗

目的：提高临床对睾丸扭转的认识。方法：回顾总结12例睾丸扭转患者的临床资料,进行分析。结果：8例行手术探查,4例手法复位成功。8例均行对侧固定,其中5例行手术切除,3例术中复位。结论：彩超在睾丸扭转的诊断中作用明显。未婚男性耻区不适是睾丸扭转的首发症状。     

精索扭转的诊治体会

目的:总结我院对精索扭转的诊治经验。方法:对我院1998年1月-2006年4月收治的12例精索扭转病人的临床资料进行回顾性分析。结果:行彩色多普勒检查6例,均确诊;12例均行手术复位,复位后5例睾丸血运恢复行睾丸固定术,7例睾丸血运无改善行坏死睾丸切除术,均痊愈出院。结论:彩色多普勒成像是诊断精索扭转的可靠方法,早期积极手术探查是提高睾丸成活率的关键。     

15例睾丸扭转的诊断和治疗

目的探讨睾丸扭转的诊断和治疗。方法对15例睾丸扭转患者的诊断处理进行回顾性分析。结果3例手法复位成功,随访3月至1年未复发;12例患者手术治疗,3例行患侧睾丸复位固定术,9例患者行患侧睾丸切除术。结论睾丸扭转是青少年阴囊急诊的主要病因之一,通过临床症状以及多普勒彩超等检查,一般能作出准确诊断。手法复位及手术探查是治疗的关键。     

睾丸扭转19例的诊治

目的 总结睾丸扭转的诊断与治疗体会,提高睾丸扭转的诊治水平.方法 回顾性分析19例睾丸扭转患者的临床资料,患者年龄8～42岁,平均19.6岁.左侧14例,右侧5例.发病至确诊时间3 h～7 d.结果 初诊误诊7例.4例发病时间短或扭转程度轻经手术复位而保留睾丸,其余15例因睾丸已坏死而予以切除.手术同时均行对侧睾丸探查固定.13例术前行彩色多普勒血流动态显象(CDFI)检查,1例发病4 h检查睾丸血流正常,第2天复查无血流,其余12例均提示睾丸无血流或血流减少.结论 CDFI检查是诊断睾丸扭转的可靠方法,早期诊断和及时治疗是提高疗效的关键,在怀疑有睾丸扭转时,应及时手术探查.     

睾丸扭转诊疗分析（附38例报告）

目的：总结睾丸扭转的诊疗经验。方法分析2002年～2012年收治的38例睾丸扭转患者的临床资料,所有患者均行超声检查,超声检查提示睾丸、附睾位置改变,睾丸内血流减少或消失。结果36例患者接受手术治疗,其中12例睾丸扭转时间＜6 h患者经手术复位后保留睾丸,2例术后随访发现睾丸较健侧睾丸体积减小。24例扭转时间＞6 h患者中,16例术中发现睾丸坏死行睾丸切除术;复位后睾丸存活5例,睾丸萎缩3例。结论睾丸扭转早期常易误诊,超声检查为首选的辅助检查手段;及早明确诊断、手术探查是避免睾丸坏死、萎缩的关键。     

彩色多普勒超声诊断和鉴别诊断小儿睾丸扭转

目的 评估彩色多普勒超声诊断及鉴别诊断小儿睾丸扭转的价值。 方法 回顾分析因急性阴囊肿痛而接受彩色多普勒超声检查的125例患儿的声像图特征,并与手术病理、临床最终诊断相比较。 结果 125例中,急性睾丸扭转14例,超声诊断符合率92.86%(13/14),均接受手术治疗,其中11例睾丸完全坏死切除,CDFI显示睾丸内无明显血流信号,3例手术复位后睾丸存活,CDFI示睾丸内有少量血流信号;急性睾丸附件扭转68例,睾丸上极或与附睾间见回声不均质结节,内无血流信号,超声诊断符合率97.06%(66/68);急性附睾炎43例,附睾内血流信号明显增多,超声诊断符合率100%(43/43)。 结论 彩色多普勒超声对小儿睾丸扭转具有较高的诊断及鉴别诊断价值,是临床首选的影像检查方法。     

彩色多普勒超声在儿童急性睾丸炎和睾丸扭转诊断中的应用

目的： 用超声鉴别儿童急性睾丸炎和睾丸扭转。方法： 应用彩色多普勒血流显像 （ＣＤＦＩ） 对临床疑诊为 “睾丸扭转”的 １５ 例患儿的患侧睾丸和健侧睾丸进行了急诊检查。结果： ３ 例彩超确诊为睾丸扭转, 急诊手术复位, 其余 １２ 例彩超发现患侧睾丸血流信号异常丰富, 诊断为急性睾丸炎, 排除了睾丸扭转。结论： 彩色多普勒血流显像在儿童急性睾丸炎和睾丸扭转鉴别中具有重要诊断价值。     

Testicular torsion

Each year, testicular torsion affects one in 4,000 males younger than 25 years. Early diagnosis and definitive management are the keys to avoid testicular loss. All prepubertal and young adult males with acute scrotal pain should be considered to have testicular torsion until proven otherwise. The finding of an ipsilateral absent cremasteric reflex is the most accurate sign of testicular torsion. Torsion of the appendix testis is more common in children than testicular torsion and may be diagnosed by the "blue dot sign" (i.e., tender nodule with blue discoloration on the upper pole of the testis). Epididymitis/orchitis is much less common in the prepubertal male, and the diagnosis should be made with caution in this age group. Doppler ultrasonography may be needed for definitive diagnosis; radionuclide scintigraphy is an alternative that may be more accurate but should be ordered only if it can be performed without delay. Diagnosis of testicular torsion is based on the finding of decreased or absent blood flow on the ipsilateral side. Treatment involves rapid restoration of blood flow to the affected testis. The optimal time frame is less than six hours after the onset of symptoms. Manual detorsion by external rotation of the testis can be successful, but restoration of blood flow must be confirmed following the maneuver. Surgical exploration provides definitive treatment for the affected testis by orchiopexy and allows for prophylactic orchiopexy of the contralateral testis. Surgical treatment of torsion of the appendix testis is not mandatory but hastens recovery.     

Testicular infarction becoming apparent after hernia reduction

Background: Testicular infarction from an incarcerated inguinal hernia is a rare event in children, often not considered in the initial evaluation. Objective: To report a case that describes the presentation, diagnosis, and management of testicular infarction in the setting of an incarcerated inguinal hernia. Case Report: A 2-month old boy was brought to the Emergency Department (ED) by his parents for vomiting, crying, and a left-sided scrotal swelling. An inguinal hernia was manually reduced successfully in the ED. Subsequently, scrotal ultrasound with color Doppler was obtained, demonstrating no blood flow to the left testis. The patient underwent a left orchiectomy and right orchiopexy with hernia repair. Discussion: Testicular injury can occur from torsion due to the effect of an incarcerated hernia or due to ischemia from cord compression. Delay in diagnosis and surgery risks testicular viability, therefore, surgery should not be delayed for imaging in the presence of strong suspicion of torsion. Conclusions: The diagnosis of testicular torsion is not always straightforward because many conditions may have a similar clinical presentation or may compromise testicular blood supply. This case is an unusual presentation of testicular infarction in the setting of an incarcerated inguinal hernia.     

The undescended testicle: diagnosis and management

Early diagnosis and management of the undescended testicle are needed to preserve fertility and improve early detection of testicular malignancy. Physical examination of the testicle can be difficult; consultation should be considered if a normal testis cannot be definitely identified. Observation is not recommended beyond one year of age because it delays treatment, lowers the rate of surgical success and probably impairs spermatogenesis. By six months of age, patients with undescended testicles should be evaluated by a pediatric urologist or other qualified subspecialist who can assist with diagnosis and treatment. Earlier referral may be warranted for bilateral nonpalpable testes in the newborn or for any child with both hypospadias and an undescended testis. Therapy for an undescended testicle should begin between six months and two years of age and may consist of hormone or surgical treatment. The success of either form of treatment depends on the position of the testicle at diagnosis. Recent improvements in surgical technique, including laparoscopic approaches to diagnosis and treatment, hold the promise of improved outcomes. While orchiopexy may not protect patients from developing testicular malignancy, the procedure allows for earlier detection through self-examination of the testicles.