Closed manual detorsion in case of a testicular torsion in children

封面

如何引用文章

全文:

详细

Aim of study. To evaluate the effectiveness of closed manual detorsion in case of testicular torsion in children of different age groups.

Materials and methods. Manual detorsion was carried out according to the classical technique (Yudin Ya.B. et al., 1987) by 79 patients with a testicular torsion at the age from the neonatal period to 18 years. A comparative analysis of the effectiveness of detorsion depending on various factors (the age of the patient, the duration of ischemia, the presence of a secondary hydrocele) was performed.

Results. The effectiveness of the detorsion depended on the duration of the ischemia period before manipulation in patients of all ages. The effectiveness of the detorsion is more pronounced in adolescents, which is due to the more advanced structures of the spermatic cord and the larger testicle mass. A hydrocele of a secondary nature is a factor complicating detorsion, but its puncture emptying increases the efficiency of manipulation.

Conclusions. The effectiveness of manual detorsion is directly proportional to the age of the patient and inversely proportional to the duration of ischemia before the manipulation is performed. The frequency of residual torsion does not allow us to consider the method as independent in the treatment of testicular torsion, and ultrasound and ultrasound dopplerography are completely reliable evaluation criteria. The effectiveness of the method allows you to recommend it in the first day of the disease in patients of all age groups, except for newborns, but emergency surgery should be performed as soon as possible after the detorsion. Carrying out a discharge puncture in patients with a secondary hydrocele against a background of testicular vesicle significantly improves the effectiveness of manual detorsion.

作者简介

Igor Shormanov

Yaroslavl State Medical University

编辑信件的主要联系方式.
Email: i-s-shormanov@yandex.ru

Doctor of Medical Science, Professor, Head of the Department of Urology and Nephrology

俄罗斯联邦, Yaroslavl

Dmitriy Shchedrov

Yaroslavl Regional Pediatric Clinical Hospital

Email: shedrov.dmitry@yandex.ru

Candidate of Medical Science, Head of the Pediatric Urology of Andrology unit

俄罗斯联邦, Yaroslavl

参考

  1. Клиническая андрология / Под ред. В.-Б. Шилла, Ф. Комхайра, Т. Харгрива; пер. с англ. Д.А. Бедретдиновой, Т.Н. Гармановой / Под ред. О.И. Аполихина, И.И. Абдуллина. – М.: ГЭОТАР-Медиа, 2011. [Clinical Andrology. Ed. by W.-B. Schill, F.H. Comhaire, T.B. Hargreav; translation from English by D.A. Bedretdinova, T.N. Garmanova. Ed. by O.I. Apolichin, I.I. Abdullin. Moscow: GEOTAR- Media; 2011. (In Russ.)]
  2. Юдин Я.Б., Саховский А.Ф. Острые заболевания яичек у детей: Методические рекомендации для врачей. – Новокузнецк, 1979. [Yudin YaB, Sakhovskii AF. Ostrye zabolevaniya yaichek u detei. Metodicheskie rekomendatsii dlya vrachei. Novokuznetsk; 1979. (In Russ.)]
  3. Окулов А.Б. Хирургическая тактика при заболеваниях органов репродуктивной системы у детей: Дис. … д-ра мед. наук. – М., 2001. [Okulov AB. Khirurgicheskaya taktika pri zabolevaniyakh organov reproduktivnoi sistemy u detei [dissertation]. Moscow; 2001. (In Russ.)]
  4. Jefferson RH, Perez LM, Joseph DB. Critical analysis of the clinical presentation of acute scrotum: a 9-year experience at a single institution. J Urol. 1997;158(3):1198-1200. doi: 10.1016/s0022-5347(01)64426-4.
  5. Бухмин А.В., Никитин И.В. Острая мошонка у детей / Материалы трудов VIII Международного конгресса урологов; 2000; Харьков. [Bukhmin AV, Nikitin IV. Ostraya moshonka u detei. (Conference proceedings) VIII Mezhdunarodnyy Kongress urologov; 2000; Khar’kov. (In Russ.)]
  6. Cornel EB, Karthaus HFM. Manual detorsion of the twisted spermatic cord. BJU International. 2001;83(6):672-674. doi: 10.1046/j.1464-410x.1999.00003.x.
  7. Snodgrass TW. Pediatric Urology Practice. New York: Springer; 2013.
  8. Эргашев И.Ш., Хакомов Т.П. Диагностика и тактика лечения при синдроме отечной мошонки у детей // Детская хирургия. – 2010. – Т. 14. – № 3. – С. 23–26. [Ergashev ISh, Khakomov TP. Diagnostika i taktika lecheniya pri sindrome otechnoi moshonki u detei. Detskaya khirurgiya. 2010;14(3):23-26. (In Russ.)]
  9. Комарова С.Ю., Цап Н.А., Чукреев В.И. Особенности консервативной и оперативной тактики при перекруте яичка // Детская хирургия. – 2016. – Т. 20. – № 4. – С. 185–188. [Komarova SYu, Tsap NA, Chukreev VI. Peculiarities of conservative and surgical treatment of testicular torsion. Detskaya khirurgiya. 2016;20(4):185-188. (In Russ.)]. doi: 10.18821/1560-9510-2016-20-4-185-188.
  10. Пулатов А.Т., Карасева О.В., Медведев И.В. О консервативном расправлении перекрута яичка у детей // Детская хирургия. – 2004. – Т. 8. – № 2. – С. 6–10. [Pulatov AT, Karaseva OV, Medvedev IV. O konservativnom raspravlenii perekruta yaichka u detei. Detskaya khirurgiya. 2004;8(2):6-10. (In Russ).]
  11. Kiesling Jr VJ, Schroeder DE, Pauljev P, Hull J. Spermatic cord block and manual reduction: primary theatment for spermatic cord torsion. J Urol. 1984;132(5):921-923. doi: 10.1016/s0022-5347(17)49947-2.
  12. Garel L, Dubois J, Azzie G, et al. Preoperative manual detorsion of the spermatic cord with Doppler ultrasound monitoring in patients with intravaginal acute testicular torsion. Pediatr Radiol. 2000;30(1):41-44. doi: 10.1007/s002470050012.
  13. Юдин Я.Б., Окулов А.Б., Зуев Ю.Е., Саховский А.Ф. Острые заболевания органов мошонки у детей. – М.: Медицина, 1987. [Judin YaB, Okulov AB, Zuev YuE, Sahovskij AF. Ostrye zabolevanija organov moshonki u detej. Moscow: Medicina; 1987. (In Russ.)]

补充文件

附件文件
动作
1. JATS XML

版权所有 © Shormanov I.S., Shchedrov D.N., 2018

Creative Commons License
此作品已接受知识共享署名 4.0国际许可协议的许可
 


Согласие на обработку персональных данных

 

Используя сайт https://journals.rcsi.science, я (далее – «Пользователь» или «Субъект персональных данных») даю согласие на обработку персональных данных на этом сайте (текст Согласия) и на обработку персональных данных с помощью сервиса «Яндекс.Метрика» (текст Согласия).