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J Pediatr Surg. 2019 Nov 9. pii: S0022-3468(19)30758-4. doi: 10.1016/j.jpedsurg.2019.10.023. [Epub ahead of print]

Effect of Pediatric Testicular Torsion on Testicular Function in the Short Term.

Author information

1
Department of Pediatric Surgery, Helsinki, Finland. Electronic address: seppo.taskinen@hus.fi.
2
Department of Pediatric Surgery, Helsinki, Finland.
3
Pediatric Research Center New Children's Hospital, Helsinki University Hospital, Helsinki, Finland; Department of Physiology, Medicum Unit, and Translational Stem Cell Biology and Metabolism Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.

Abstract

PURPOSE:

To evaluate short-term testicular outcome after torsion in children.

METHODS:

Fifty-four children and adolescents were evaluated after 6 months of the operation for testicular torsion. Testicular volume was measured and circulating Inhibin B, FSH, LH and testosterone levels were checked.

RESULTS:

Delay from the onset of symptoms to surgery was shorter in the orchidopexy group (n = 47), than in the orchiectomy group (n = 7, p = 0.001). In the orchidopexy group, the median volume of the affected testis was 83% (IQR 43-104) of the contralateral testis (p = 0.002). The plasma hormone levels in orchidopexy and orchiectomy groups were: 148 ng/l (IQR 108-208) vs. 129 ng/l (IQR, 123-138, p = 0.269) for Inhibin B; 4.5 IU/L (IQR2.6-6.9) vs. 11.7 IU/L (IQR 4.3-12.8, p = 0.037) for FSH; 2.9 IU/L (IQR 1.3-3.7) vs. 4.8 (IQR 3.0-5.6, p = 0.066) for LH; and 13.6 nM (IQR 6.5-18.0) vs. 14.5 nM (IQR 6.7-15.9, p = 0.834) for testosterone. The association between FSH, LH as well as testosterone levels was most clear with the volume of the contralateral testis (Rho = 0.574, p < 0.001, Rho = 0.621, p = 0.001 and Rho 0.718, p < 0.001 respectively).

CONCLUSIONS:

Testicular function is mainly dependent on the volume of contralateral testicle after testicular torsion. However, testis preserving surgery tends to maintain better function than orchiectomy.

TYPE OF STUDY:

Retrospective review.

LEVEL OF EVIDENCE:

III.

KEYWORDS:

FSH; Fertility; Inhibin B; Testicular torsion; Testis

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