Risk factors analysis of testicular atrophy after torsion reduction in children
Objective:To study the risk factors of testicular atrophy after torsion reduction and fixation in chil-dren,and to explore the index of predicting testicular atrophy.Methods:The clinical data of 72 children who un-derwent testicular torsion reduction and fixation in our hospital from January 2018 to December 2022 were retro-spectively analyzed.The age ranged from 1 to 13 years,with an average age of(7.31±0.32)years.The patients were followed up for 6 months.According to the results of postoperative ultrasound,the patients were divided in-to testicular atrophy group and non-testicular atrophy group.The data of the two groups were analyzed by univari-ate analysis,and the factors with statistically significant differences were included in the multivariate logistic re-gression model.The risk factors of testicular atrophy after reduction of testicular torsion were analyzed.Results:All the 72 children underwent testicular torsion reduction and fixation,among whom 39 cases had testicular atro-phy after surgery,and 33 cases did not have testicular atrophy.Univariate analysis showed that there were no sig-nificant differences in age,scrotal redness and swelling,or preoperative white blood cell count between the two groups(P＞0.05).There were significant differences in the duration of preoperative pain,the appearance of pre-operative ultrasound heterogeneity,and the color score after 10 minutes of testicular torsion between the two groups(P＜0.05).Multivariate logistic regression analysis showed that the duration of preoperative pain＞12 hours,color score of 1-2 at 10 minutes after reduction of testicular torsion,and the heterogeneous echo of testic-ular parenchyma on preoperative ultrasound were independent risk factors for testicular atrophy after reduction and fixation of testicular torsion in children(P＜0.05).Conclusion:The color score of 1-2 at 10 minutes after reduc-tion of testicular torsion indicates that the testis has been irreversibly damaged,and the probability of orchiectomy is high.Even if the testes are preserved during the operation,the rate of testicular atrophy is high.Preoperative pain duration＞12 hours and preoperative ultrasound heterogeneity are risk factors for testicular atrophy after tes-ticular torsion reduction.When testicular torsion is suspected,active surgical exploration should be performed to reduce the testicular ischemia time and thus maximize the possible preservation of the testis.
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