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CONGRESS OF THE ESPU
S9-8 (P without presentation)
TESTICULAR FIXATION FOR TESTICULAR TORSION:
IS THERE ANY NEED?
José A MARCH-VILALBA, Beatriz PEMARTÍN-COMELLA, Elena CARAZO-
PALACIOS, Agustín SERRANO-DURBÁ, Alba POLO-RODRIGO, Ivan POVO-MARTÍN
and Carlos DOMÍNGUEZ-HINAREJOS
La Fe Universitarian Hospital, Pediatric Urology Department, Valencia, SPAIN
PURPOSE
Assessment of the indication for bilateral fixation of the testis during the surgical exploration of
a testicular torsion.
MATERIAL AND METHODS
Prospective study of 69 patients undergoing surgery for testicular torsion between 1996 and 2014.
We evaluated epidemiological characteristics (age, side, duration and background), fixation of both
testicles, type of fixation and long and short term outcomes of both gonads (recurrent torsion, fertility
and evolution).
RESULTS
Average age was 10, 85 years (DS 4.6 years). In 18 patients (26%) orchiectomy was performed.
Detorsion was performed in the other 51 patients, being 43.1% right side testicular torsion and
56.9% left side testicular torsion. Only in 4 patients the contralateral testis were fixed, and in
47 (92.1%) contralateral testis were not fixed. Regarding the torsed testicle: in 26 (50.9%) patients
the testis were fixed by sutures through the tunica vaginalis, in 25 (49.1%) cases the torsed testis
was not fixed. Median follow-up was 12.75 years (1.5 - 20 years) with no evidence of retorsion in
either group, or torsion of the contralateral testis. Long term percentage of atrophy of the affected
testicle was 8% for the fixed testicles and 19% for not- fixed testicles. (Chi square= 1.35, p=0,41).
CONCLUSIONS
Taking into account the low incidence of recurrent torsion, in our experience, there is no indication
for ipsilateral and/or contralateral fixation of the testis. It should be enough warning the patient
about the importance of being evaluated soon by a specialist in the emergency department, if a new
episode of scrotal pain appears.
S9-9 (P without presentation)
EFFECT OF SURGICAL TECHNIQUE ON FERTILITY
IN BILATERAL UNDESCENDED TESTIS
Mick UIJLDERT
1
, Andreas MEIßNER
2
, Caroline KUIJPER
1
, Sjoerd REPPING
3
,
Tom DE JONG
4
and Rafal CHRZAN
5
1) Academic Medical Center, Pediatric Urology, Amsterdam, NETHERLANDS - 2) Academic Medical Center,
Urology, Amsterdam, NETHERLANDS - 3) Academic Medical Center, Center for Reproductive Fertility, Amsterdam,
NETHERLANDS - 4) University Medical Center Utrecht, Pediatric Urology, Amsterdam, NETHERLANDS -
5) Jagiellonian University, Pediatric Urology, Krakow, POLAND
PURPOSE
Bilateral undescended testis (BUDT) is associated with abnormal semen parameters in up to 94%
of cases and a high azoospermia rate of 9-15%. Paternity is achieved in 38-60% of attempts.
A negative influence on testicular growth and spermatogenesis in animals was demonstrated when
a fixation through the tunica albuginea was used. This study aims to assess the long term results of
a tunica albuginea orchidopexy (TAO) compared to a “no touch” technique (NTO).