Traumatic testicular torsion in a patient with a solitary testicle. Management with conservative surgery

Abstract

Objective: To present a case of testicular torsion managed with conservative surgery in order to begin to generate scientific evidence related to these cases. Where conservative surgery is warranted, at the Urology Service at Hospital General De Accidents "EL CEIBAL" Guatemala. Background: Testicular torsion is considered a frequent clinical entity in infants, infrequent in young adults and less frequent due to trauma 5-6%. Materials and methods: We report the case with photographs of a 28-year-old male patient, with a history of testicular torsion secondary to trauma, who was managed with conservative surgery due to a history of orchidectomy in his childhood. Having a first surgical intervention we performed surgery. For manual testicular distorsion and a second intervention in 48 hours to evaluate results and testicular viability, which were satisfactory, so orchidectomy was not performed. Results: The patient had a satisfactory evolution with resolution of testicular pain and ischemic changes without the need for orchidectomy. Conclusions: It is known that after 6 hours it is very unlikely that there is reversion of the ischemia in the testicle secondary to torsion, however, individualizing the case of the patient considering a valuable solitary testicle, treatment is given with conservative surgery and has a favorable evolution. The patient must be monitored, closely since at with at the minimum change must to monitored in his metabolic and inflammatory state, he must reoperate and perform orchidectomy.