title: Testicular torsion: a 15-year single-centre clinical and histological analysis.
abstract: OBJECTIVE
  This study reviewed the demographic, epidemiological and clinical factors of boys seen at a single centre who underwent surgical exploration for testicular torsion.
  
  
  METHODS
  Retrospective single-centre review of boys with testicular torsion between 1996 and 2011 was made.
  
  
  RESULTS
  Testicular torsion (right n = 43, left n = 60, bilateral n = 1) was identified in 104 boys between 0 and 18 years. Ten newborns presented with 11 intrauterine torsions. Nine torsions presented in undescended inguinal testes (one intrauterine). In 94 boys with descended testes, presentation included pain (76%), scrotal swelling (65%) and abdominal symptoms (22%). Ultrasonography was performed in 85 patients with false-negative results in 4 (4.7%). Orchiectomy was performed during initial exploration in 41, with significantly higher rates of orchiectomies in patients with late (>6 h) versus patients with early referrals (<6 h) (56% vs. 9.1%). Histological evaluation was carried out in 68 testes, with 43 resected testes demonstrating haemorrhagic necrosis. In 25 biopsied testes, histology revealed acute parenchymal bleeding (n = 14), onset of parenchymal infarction (n = 8), orchitis (n = 1) and normal tissue (n = 2). Eighty-two patients were followed up with pathological findings in four patients: testicular atrophies requiring orchiectomy (n = 2), testicular autolysis (n = 1) and small testicular vein thrombosis (n = 1).
  
  
  CONCLUSIONS
  Chances of testicular salvage after torsion are higher if patients present early. The majority of patients presenting late (>6 h) require orchiectomy owing to testicular necrosis.
authors.affiliation: Department of Pediatric and Adolescent Surgery, Medical University of Graz, Austria. amulya.saxena@medunigraz.at
authors.forename: A K
authors.initials: AK
authors.lastname: Saxena
authors.forename: C
authors.initials: C
authors.lastname: Castellani
authors.forename: E M
authors.initials: EM
authors.lastname: Ruttenstock
authors.forename: M E
authors.initials: ME
authors.lastname: Höllwarth
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001317:Austria / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009336:Necrosis; D009919:Orchiectomy; D011379:Prognosis; D012189:Retrospective Studies; D013086:Spermatic Cord Torsion / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D013737:Testis / Q000473:pathology; D018608:Ultrasonography, Doppler