Abstract

Objective: Intrascrotal pathologies in childhood are characterized with variable degrees of ; scrotal pain, swelling, and/or sensitivity. In this study, we aimed to evaluate retrospectively the patients diagnosed with appendix testes tortion and testes tortion, common causes of intrascrotal pathologies.

Materials and Methods: In this study, 18 patient with testes torsion and 2 patients with appendix testes torsion were evaluated between January 1993 and December 2006. The age range of the patients was 3 days-168 months.. The patients were assessed for the complications upon presentation, diagnosis algorithms, and the treatments applied.

Results: The age range of the patients was 3 days-168 months, and the mean age was 104.1±73.2 months. Scrottal pain was the most common complaint upon presentation in the patients with testes torsion. . In physical examination, there were swelling and sensiti-vity in the spermatic cords in two patients (11.1%), and there were non-specific findings such as local erythema, sensitivity, and scrottal swelling in 12 patients (66.7%), and there was fewer in 6 patients (32.3%). There was the absence of cremasteric reflex in 18 patients (100%). In testes torsion, conclusive diagnosis was obtained by means of color –Doppler ultrasonography. The sensitivity of color-doppler ultrasonography was 94% and specificity, 100%. In testes tortion, for 3 of 4 patients presenting within the first 12 hours of torsion, manual detorsion was applied (16.7%); for one patient, surgical detorsion and fixation of the scrotum of both testes were performed. For 14 patients presenting after the 24t hour of torsion, orchiectomy and fixation of coounter-testes wererecommended. Eight of 14 patients consented to surgical intervention. For these patients, orchiectomy and suitable fixation for the scrotum of the counter-testes were applied.

Conclusion: Scrotal Color-Doppler ultrasonography is the most useful method in selective diagnosis of scrotal pathologies. After the early and true diagnosis, suitable treatment will positively affect the sexuality and fertility of these children.