Khaled Mohamed Hafez Almekaty
Objective: The aim of this study was to investigate the use of intraoperative scrotal Doppler ultrasound (SDU) in cases of testicular torsion with questionable viability.
Methods: Eighty-two patients with unilateral testicular torsion were included. Surgical exploration was performed as soon as possible and hot packs were applied. If testicular color improved, the gonad was preserved and if it remained black, orchiectomy was carried out. In equivocal cases, we used SDU to assess testicular blood flow intraoperatively. The cases that showed an evidence of arterial flow to the affected testis underwent orchiopexy, otherwise orchiectomy was done. All cases were followed up for six months.
Results: Mean patient age was 14.88 ± 4.46 years and the interval between the onset of symptoms and surgical intervention ranged from 5 to 56 hours. After complete detorsion of the affected testes, 25 testes were subjectively viable and orchiopexy was done. 29 patients had black gangrenous testes, and the decision of orchiectomy was easily justified for them. There were also 28 equivocal cases and SDU was applied to them. Out of them, 18 patients were found to be suitable for orchiopexy and the rest underwent orchiectomy. After six months, of the 18 equivocal cases who underwent testicular preservation, only five (27.8%) showed testicular atrophy.
Conclusion: The use of intraoperative SDU is helpful in decision making for equivocal cases of testicular torsion.
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