RT Journal Article
A1 Cigsar Kuzu, Emine Burcu
A1 Tiryaki, Sibel
A1 Guney, Neslihan
A1 Polatdemir, Kamer
A1 Cakir, Yasemin
A1 Karagozlu Akgul, Ahsen
A1 Toper, Muhammed Hasan
A1 Karaguzel, Gungor
A1 Ucar, Murat
A1 Bassorgun, Cumhur Ibrahim
A1 Ozel, Seyhmus Kerem
A1 Ozkanli, Seyma
A1 Salci, Gul
A1 Aydin Mungan, Sevdegul
A1 Yilmaz, Mehmet Ugur
A1 Aytac Vuruskan, Berna
A1 Yagmur, Ismail
A1 Tarini, Emine Zeynep
A1 Kaba, Meltem
A1 Tanik, Canan
A1 Canbaz, Furkan Adem
A1 Hurdogan, Ozge
A1 User, Idil Rana
A1 Orhan, Diclehan
A1 Atici, Ahmet
A1 Gursoy, Didar
A1 Yagmurlu, Emin Aydin
A1 Enneli, Duygu
A1 Kilic, Seref Selcuk
A1 Erdogan, Seyda
T1 Low-Grade Injury following Testicular Torsion: A Multicenter Study Confirming a Disturbing Possibility
JF Urologia Internationalis
JO Urol Int
YR 2023
DO 10.1159/000534454
SP 1
OP 6
SN 0042-1138
AB Introduction: There is an ongoing debate whether to perform orchiectomy or orchidopexy following testicular torsion (TT) in cases where the testis seems non-viable. The main problem is lack of objective criteria defining testicular viability. The aim of this study was to investigate the grade of injury in orchiectomy specimens obtained from cases of TT and its association with clinical findings. Methods: This multicenter retrospective study involved double-blinded reassessment of the patient files and the pathological specimens using Mikuz classification to analyze the relation between clinical and pathological findings. Results: A total of 289 patient charts from 14 centers were reviewed and 228 were included in this study. Twenty (8.8%) patients had grade 1 injury which refers to reversible injury. The clinical findings of these 20 patients were compared to 208 patients with higher grades of injury. As expected, there was statistically significant difference regarding duration of symptoms (p < 0.001); however, range was wide in both groups (as long as 96 h for grade 1 and as short as 7 h for higher grades). There was no statistically significant difference in any other variable including age (median 14 for both, p = 0.531), symptoms (pain: 19/20 vs. 189/202, p = 0.801; swelling: 13/19 vs. 168/197, p = 0.094), absence of blood flow in Doppler US (15/19 vs. 164/197, p = 0.635), or degree of torsion (median 720° for both, p = 0.172). Conclusion: Our study revealed necessity for better criteria to define viability of testis following TT. Histopathological injury appeared to be reversible even in some patients with more severe perioperative findings, late admission, or high degree of twisting. Our findings support the tendency for testicular fixation instead of orchiectomy as none of the clinical or perioperative findings could be attributed to high-grade injury. 
RD 11/3/2023
UL https://doi.org/10.1159/000534454