[Diagnosis and treatment of 109 cases of testicular torsion in children and adolescents].

To investigate the diagnosis and treatment of testicular torsion in children and adolescents and to analyze the postoperative outcomes.We retrospectively analyzed 109 cases of unilateral testicular torsion treated in our hospital between 2015 and 2017, including 62 cases of left (56.9%) and 47 cases of right torsion (43.1%), and 98 cases of intravaginal (89.9%) and 11 cases of extravaginal torsion (10.1%), clinically 96 cases with scrotal pain (88.1%), 70 with scrotal redness and swelling (64.2%), 25 with abdominal pain (22.9%), and 33 with nausea and vomiting (30.3%). The patients ranged in age from 4 days to 15 years, averaging 9.7 ± 3.3 years, and fell into 3 groups according to the time of onset: <12 h, 12－24 h and >24 h. We analyzed the results of scrotal ultrasonography, clinical manifestations, and intraoperative and follow-up data of the patients.Scrotal ultrasonography showed no or decreased testicular blood flow in 96 cases (88.1%) and unconspicuously reduced testicular blood flow with scrotal wall thickening and vaginal sac effusion in 13 cases (11.9%). Eighty-three (76.1%) of the patients were treated by orchiectomy and the other 26 by testis-sparing surgery. Of the latter 26 cases, 2 were lost to follow-up, 16 (66.6%) achieved testis survival, and 8 (33.3%) developed testicular atrophy at 6 months after surgery. The rates of orchiectomy were 9.1%, 47.4% and 92.4%, and the incidences of postoperative testicular atrophy were 10.0%, 25.0% and 83.3% in the <12 h, 12－24 h and >24 h groups, respectively, both with statistically significant differences among the three groups (P < 0.01).Testicular torsion is common in children and adolescents, with clinical symptoms of scrotal pain, scrotal redness, abdominal pain, and nausea and vomiting. Scrotal ultrasonography can effectively display the status of testicular blood flow, and surgery is the most accurate treatment. Testis-sparing surgery is most valuable for the cases with the onset time of <12 hours, while orchiectomy is preferable for those with the onset time of >24 hours.