Torsion of the testis in childhood

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Abstract
Sixty cases of clinically diagnosed torsion of the testis have been admitted to a paediatric surgical unit over a period of 25 years. Of the 42 cases proved at operation to have torsion, 19 (46 per cent) underwent immediate orchidectomy, and a further 14 (33 per cent) showed partial or complete atrophy of the testis at follow-up at least 2 years postoperatively. The salvage rate was therefore only 21 per cent. Early diagnosis and immediate exploration may save a few cases from orchidectomy, but delay in referral remains the substantial factor determining viability. The importance of fixation of the surviving testis is stressed and contralateral orchidopexy at the time of the emergency procedure is recommended, Twelve cases of idiopathic scrotal oedema and 6 cases of proved torsion of the appendix testis were encountered over the same period and their clinical features are described. Symptomatology is milder in these two conditions and it is possible that a proportion of the 30 cases diagnosed as having epididymo-orchitis in fact suffered from torsion of the appendix testis.

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