Pediatr Emerg Med J.  2025 Apr;12(2):83-86. 10.22470/pemj.2025.01228.

Recurrences of testicular torsion after manual detorsion: a single institution experience

• Hosokawa T

• KMID: 2567076
• DOI: http://doi.org/10.22470/pemj.2025.01228

Abstract

Testicular torsion needs prompt detorsion to prevent testicular necrosis. Manual detorsion has recently gained acceptance as an initial treatment. The aim of this study was to assess the recurrence rate of testicular torsion in patients who underwent successful detorsion but did not receive immediate orchiopexy. Among the 27 patients, 3 (11%) experienced the recurrences 35, 80, and 340 days after successful detorsions. In our limited cohort, recurrences did not occur during the acute phase after the detorsions; instead, they occurred months later. Therefore, orchiopexy should be timely performed after manual detorsion.

Keyword

Emergencies; Emergency Treatment; Orchiopexy; Scrotum; Spermatic Cord Torsion

Reference

References

1. Qi X, Yu J, Ding X, Wang Y, Zhu H. Manual reduction in testicular torsion and subsequent treatment after successful reduction: a series of reports in a single institution. Front Pediatr. 2024; 12:1362104.

2. Vasconcelos-Castro S, Flor-de-Lima B, Campos JM, Soares-Oliveira M. Manual detorsion in testicular torsion: 5 years of experience at a single center. J Pediatr Surg. 2020; 55:2728–31.

3. van Doeveren T, Somani BK, T Hoen LA, Haensel SM. Real-world management of testicular torsion: level of adherence to the EAU Pediatric Urology guidelines. J Pediatr Urol. 2023; 19:117–24.

4. Cabral Dias Filho A, Rincon Cintra da Cruz P, Zanettini Riccetto CL. Testicular torsion patients should be manually detorsed at diagnosis: a propensity score matched analysis of the influence of interhospital transfer and surgical wait times on surgical organ salvage. Pediatr Emerg Care. 2022; 38:e936–42.

5. Yığman M, Ekenci BY, Durak HM, Karakoyunlu AN. Predictive factors for manual detorsion success in testicular torsion. Int Urol Nephrol. 2024; 56:3797–804.

6. Russo T, Cozzi DA, Gaglione G, Ceccanti S. The role of manual detorsion in pediatric testicular torsion during the global COVID-19 pandemic: experience from 2 centres. Urology. 2023; 180:227–34.

7. West JM, Goates AJ, Brown JA. A 26-year-old male with a 14-year history of left intermittent testicular torsion treated with self-manual reduction. Curr Urol. 2018; 11:166–8.

8. Cho PS, Yu RN, Paltiel HJ, Migliozzi MA, Li X, Venna A. Clinical outcome of pediatric and young adult subclinical varicoceles: a single-institution experience. Asian J Androl. 2021; 23:611–5.

9. Yurtcu M, Kozacioglu S, Kocabas R. The effects of orchiectomy and steroid on fertility in experimental testicular atrophy. Clin Exp Reprod Med. 2023; 50:94–8.

10. Hosokawa T, Tanami Y, Sato Y, Oguma E. Point-of-care ultrasonography for the diagnosis and manual detorsion of testicular torsion. J Med Ultrason. 2024; 51:59–70.

11. Smith WT, Midgley S, Kummer T. Real-time ultrasound-guided manual testicular detorsion: a case report. Clin Pract Cases Emerg Med. 2022; 6:248–51.

12. Vazquez JL, Fernandez MJ, Comendador-Morales A, Prada-Arias M. Testicular torsion and ultrasound-assisted manual detorsion. Pediatr Radiol. 2024 Aug 8 [Epub]. https://doi.org/10.1007/s00247-024-06008-1.

13. Hosokawa T, Tanami Y, Sato Y, Ishimaru T, Kawashima H, Oguma E. Role of ultrasound in manual detorsion for testicular torsion. J Clin Ultrasound. 2021; 49:860–9.

14. Taghavi K, Dumble C, Hutson JM, Mushtaq I, Mirjalili SA. The bell-clapper deformity of the testis: the definitive pathological anatomy. J Pediatr Surg. 2021; 56:1405–10.

15. Caesar RE, Kaplan GW. Incidence of the bell-clapper deformity in an autopsy series. Urology. 1994; 44:114–6.

16. Bandarkar AN, Blask AR. Testicular torsion with preserved flow: key sonographic features and value-added approach to diagnosis. Pediatr Radiol. 2018; 48:735–44.

17. Masci G, Cazzato G, Milano G, Ciolli G, Malerba G, Perisano C, et al. The stiff elbow: Current concepts. Orthop Rev (Pavia). 2020; 12(Suppl 1):8661.