急性陰嚢症50例の臨床的検討 : 特に精索捻転症を中心に

Abstract

1)内訳は精索捻転症24例, 付属小体捻転症9例, 陰嚢内血腫11例, 急性精巣上体炎4例, 精巣腫瘍内出血2例. 2)精索捻転症で治療成績を左右するゴールデンタイムは12時間前後と考えられたが, 7時間で摘除術が施行された症例もあり, 可能な限り早期に外科的治療をすべきである. 3)他科医師の認識不足により精巣摘除術が余儀なくされた症例もあり, 一般医師に対する精索捻転症についての認識を高めることが重要である

Surgical exploration was done on 50 patients with acute scrotum between June 1982 and October 1995. Of them, 24 (48%) had torsion of the spermatic cord, 9 (18%) had torsion of the appendage testis, 11 (22%) had intrascrotal hematoma, 4 (8%) had acute epididymitis, and 2 (4%) had bleeding of testicular tumor. The patients who had torsion of the spermatic cord were between 0 and 26 years of age (the mean: 14.6); 9 had torsion on the right side, and 15 on the left side. Infectious manifestations occurred in about 30%, and Prehn's sign developed in 37.5%. Of all cases, orchiopexy was performed in 10 cases and orchiectomy in 14. The testis was saved in 8 (88.9%) of the 9 patients who underwent surgery within 12 hours after onset. On the contrary, the testis was saved in only 2 (13.3%) of the 15 patients who underwent surgery more than 12 hours after onset. We concluded that early consultation, and exploration by a urologist are obligatory in the treatment of torsion of the spermatic cord.