Torsion of the Spermatic Cord: Is Bilateral Orchidopexy Really Necessary?

Abstract

Aim: To evaluate the rationale for bilateral orchidopexy as treatment for unilateral torsion of the testis, by determining how frequently the contralateral testis shows an abnormal pathology in unilateral testicular torsion. Patients and Methods: This is a retrospective, study using adult urology patients treated for both acute and intermittent torsion of the testes in UNTH Enugu and a private Urology clinic in Enugu from January 2000 to May 2002. The study relies on information obtained from patients case notes. Most of the cases were treated by the authors. Results: Fifty cases (100 testes) were studied. Ages tanged between 14 to 45 years with a mean of 22.5 years. Peak incidence was in the 20-29 years age group: 25 patients (50%). Testicular pain was the chief presenting symptom (87.2% of cases). Commonest findings were horizontal lie (27%) and clapper bell deformity (23%). The pathology causing torsion was unilateral in 23 (46%) of cases and bilateral in 25 (50%)of cases: Conclusion: The observed incidence of bilateral abnormality 25 patients (50%) was found to be statistically significant (P<0.05) thus buttressing the need for bilateral orchidopexy as standard treatment for unilateral torsion of the testes.

Keywords

• torsion
• spermatic cord
• orchidopexy