Recidiverende testiculaire torsie 27 jaar na eerdere orchidopexie: casusbespreking

G. Nougon, G. Lefebvre, M. Duesberg
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Abstract

Recurrent testicular torsion 27 years after previous orchidopexy: a case report A recurrent testicular torsion after a previous orchidopexy is a rare phenomenon that requires a high index of suspicion to avoid misdiagnosis and delayed treatment. This case intends to emphasize the importance of considering a recurrent testicular torsion in the differential diagnosis of acute scrotal pain, regardless of the patient’s age. The case involves a 45-year-old man with a history of a bilateral testicular fixation for a testicular torsion at the age of 18. The patient presented with recurrent testicular pain, despite the fact that both testes previously had been fixed to the scrotal wall. This case illustrates that a recurrent testicular torsion can manifest even when the testis is fixed to the scrotal wall. This emphasizes the importance of including a recurrent testicular torsion in the differential diagnosis of acute scrotal pain. Furthermore, during the surgical intervention particular attention should be given to ensuring a proper fixation of both testes using non-absorbable sutures at a minimum of 2 points to reduce the risk of a recurrent torsion. A recurrent testicular torsion following a previous orchidopexy is a rare condition that requires vigilance in case of acute scrotal pain. This case report reinforces the need for a thorough examination and emphasizes the importance of safe testicular fixation during surgery to minimize the risk of recurrence. The threshold for surgical exploration should always be kept low, even after a previous orchidopexy.
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睾丸扭转术后 27 年复发:病例报告
既往睾丸切除术 27 年后复发的睾丸扭转:病例报告 既往睾丸切除术后复发的睾丸扭转是一种罕见现象,需要高度怀疑,以避免误诊和延误治疗。本病例旨在强调在急性阴囊疼痛的鉴别诊断中考虑复发性睾丸扭转的重要性,无论患者的年龄如何。该病例涉及一名 45 岁的男性,他在 18 岁时曾因睾丸扭转接受过双侧睾丸固定术。尽管患者的双侧睾丸曾被固定在阴囊壁上,但他还是反复出现睾丸疼痛。这个病例说明,即使睾丸固定在阴囊壁上,也可能出现复发性睾丸扭转。这强调了将复发性睾丸扭转纳入急性阴囊疼痛鉴别诊断的重要性。此外,在手术治疗过程中,应特别注意使用至少两点的非吸收性缝合线对双侧睾丸进行适当的固定,以降低再次发生扭转的风险。既往睾丸切除术后复发睾丸扭转是一种罕见情况,在出现急性阴囊疼痛时需要提高警惕。本病例报告强调了彻底检查的必要性,并强调了手术中安全固定睾丸的重要性,以最大限度地降低复发风险。手术探查的门槛应始终保持在较低水平,即使是在之前进行过睾丸切除术之后。
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