- 作者：Michael Boettcher ; michboettcher@gmail.com ; Robert Bergholz ; Thomas F. Krebs ; Katharina Wenke ; Daniel C. Aronson
- 刊名：Urology
- 出版年：2012
- 出版时间：March, 2012
- 年：2012
- 卷：79
- 期：3
- 页码：670-674
- 全文大小：256 K
Objective
To distinguish the prognostic factors that decrease the probability of a negative exploration for ¡°acute scrotum.?In some institutes, patients with ¡°acute scrotum?undergo immediate exploration after clinical evaluation. Because testicular torsion (TT) accounts only for a fraction of these cases, most infants can be treated conservatively.Methods
We performed a retrospective study of all patients treated at our institute from January 2008 to December 2009 for the diagnosis of ¡°acute scrotum.?Differences between groups were calculated using the chi-square test or analysis of variance and Mann-Whitney-Wilcoxon test for univariate or multivariate analysis, expressed as odds ratios (ORs) and 95 % confidence intervals (CIs).
Results
The data from 138 patients were analyzed. The mean age was 9 years, 8 months. Of the 138 patients, 19 (13.8 % ) had TT. This group was compared with the boys without TT at exploration. The patients with TT were older on average (11 years, 1 month vs 9 years, 1 month, p = .035). Pain for <24 hours (OR 4.2, 95 % CI 1.3-13.4), nausea and/or vomiting (OR 21.6, 95 % CI 4.9-93.4), abnormal cremasteric reflex (OR 4.8 95 % CI 0.7-35.2), and a high position of the testis (OR 18.0 95 % CI 1.8-177.1) were associated with an increased likelihood of torsion. In the group of boys with ? of these findings present, 100 % had TT at exploration, with 0 % false-positive results.
Conclusion
TT is uncommon among the group of boys treated for ¡°acute scrotum.?In particular, a pain duration <24 hours, nausea or vomiting, a high position of the testis, and an abnormal cremasteric reflex had a positive prognostic value for TT. A clinical score might help to avoid unnecessary explorations. In the future, we intend to test the diagnostic set described combined with ultrasonography.