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Year : 2000  |  Volume : 5  |  Issue : 1  |  Page : 10-13

Intermittent testicular torsion

Urology Unit, Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Nigeria

Correspondence Address:
Aloy E Aghaji
Urology Unit, Department of Surgery, University of Nigeria Teaching Hospital, Enugu
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Source of Support: None, Conflict of Interest: None

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The aim of this study is to determine the prevalence and clinical features of intermittent testicular torsion in Enugu, Nigeria. All the patients seen in two health institutions in Enugu over a six-year period, with intermittent testicular torsion, were the subjects of this study. After history taking and physical examination, the patient's scrotum was explored and all the operative findings both in the ipsilateral and contralateral testes were noted. Testicular biopsy was taken from the affected side and all the patients had bilateral orchidopexy and were billed for follow-up for six months. A total of 69 patients with testicular torsion were treated during the study period. Out of these, 42 patients had intermittent testicular torsion, giving a prevalence of 60.9%. Their ages ranged from 10-43 years, with a mean of 23.8 years. All patients complained of intermittent pains in the scrotum. The duration of symptoms before presentation ranged from 6 months to 8 years. Majority of patients (66.7%) presented after having at least 20 attacks. Pain was felt unilaterally in 34 cases and bilaterally in 8 cases, but was commonest on the left (23 cases). On palpation of the scrotum, only 56.0% of the 50 affected testes were found to be mildly tender while the rest had no tenderness. Horizontal lie was found in only 38.0% of testes while the rest had normal lie. Epididymis was anterior to the testis in only 8.0% of the affected testes. At surgery, all the affected testes were found to have one form of abnormality or the other, clapperbell deformity being the commonest (76.0%). In the contralateral testes, clapperbell deformity was still the commonest finding (61.8%) while 17.6% were found to have no abnormality. The size of the testis was normal in 68.0% of the affected testes while the rest were either small or atrophic. Histology of the affected testis was normal in 38.0% while the rest showed either peritubular fibrosis (46.0%) or frank testicular atrophy (16.0%). Follow-up for six months in 35 patients showed no recurrence of symptoms and no reduction in testicular size. Diagnosis of intermittent testicular torsion should be urgently considered in young men with recurrent scrotal pains. Prompt management of this will avoid the possible ugly sequalae of vanishing testis, infertility and sterility.

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