A Clinical Observation on the Spermatic Cord Torsion

Ryoo, Hee Soo; Kim, Kee Seo

Abstract

Torsion of the spermatic cord is an uncommon disease that is almost limited to prepubertal males. It causes strangulation to the blood supply to the testis, therefore requires urgent evaluation and diagnosis with immediate therapy to achieve preservation of a viable testicle. The patient suddenly develops severe pain in involved testicle, followed by swelling of the organ, reddening of the scrotal skin, lower abdominal pain, nausea and vomiting. The cryptorchid testis is prone to undergo torsion. A clinical study was made on 5 cases of spermatic cord torsion during the 18 months period from April, 1980 to December, 1981. The results were as follows: 1. The ages of the patients ranged from 45 drays of 16 years. Right side to left side ratio was 4:1. 2. The most common symptom of spermatic cord torsion was painful scrotal swelling. 3. Two cases were developed in undescended testicles and a case in the allergic purpura. 4. Twisted angle of the spermatic cord torsion was 1800 in 2 cases and 3600 in 3 cases. Type of torsion was extravaginal in 3 cases, and intravaginal in the other 2 cases. 5. Two cases were seen after 56 hours of onset. The involved testicles showed grossly complete necrosis and were orchiectomized. In the other 3 cases, immediate detorsion with fixation was given within 10-16 hours after onset. 6. histopathologic finding showed hemorrhagic infarction and necrosis of the testis, epididyrnis and spermatic cord in the orchiectomized cases, and generalized edematous change of epididymis and slightly separated seminiferous tubules by stromal edema in the cases of testicular preservation.