Role of Echo Doppler in Diagnosing the Testicular Torsion-Retrospective Study

Abstract

Introduction: Acute scrotum is a wide term that is used for cases that presenting with scrotal swelling and pain. Etiology can be infectious or strangulation from torsion of the testis, depending on its clinical diagnosis, requires surgical intervention or medical treatment.Aim of study: Aim of this study was to determine the rate of accuracy of the Echo Doppler scanning in the diagnosis of the testicular torsion. Considering that there are different protocols in diagnosis, some suggest surgical exploration, while some Hospitals report 100% accuracy in diagnosis of testicular torsion with Doppler ultrasound.Materials and methods: We retrospectively evaluated 4 year period, from 2011-2014, during this time all the patients that were admitted as acute scrotum where evaluated excluding the cases that were incarcerated hernias. In all admitted patients, physical examination, lab analysis and Echo Doppler study were performed.Results: In total, there were 83 patients, based on physical examination, lab and Echo Doppler scan, 50 cases were diagnosed as epididymo-orchititis, 21 cases were patients with testicular torsion and 12 cases were torqued hydatid of Morgagni. In 3 patients false positive blood circulation in affected testis was detected with Echo Doppler scan. In following days they were operated and gangrene of testis was found.Discussion: Complete absence of intratesticular blood flow and normal extratesticular blood flow on color Doppler images is diagnostic, if the flow is normal in the contra lateral testis. Color Doppler has a very high accuracy in detecting the obstacles in blood flow, but as with other diagnostic techniques, this should be not taken as granted.Conclusion: Testicular torsion is real urological emergency. Delay in diagnosis and management can lead to the loss of the testis. If there any doubts are present, urgent surgical exploration is indicated.

Keywords: Testicular torsion, acute scrotum, echo Doppler, diagnostic techniques, management