精索捻転症15例の臨床的検討

Abstract

過去10年間の15例は10～40, 平均21.1歳であった.右停留精巣の1例以外は全て左側に発生した.発症時刻が判明している13例中12例で睡眠中及び起床後1時間以内に発症していた.停留精巣1例以外の全例が精巣痛を訴え, 少数は鼠径部及び下腹部の疼痛を伴っていた.大多数で精巣の腫脹・圧痛が認められ, 精索の短縮は捻転及び2次的炎症によると思われ, 重要な所見であった.Prehn徴候及び発熱は数例にみられたが, 白血球数増加は10例に認められた.手術11例中10例で精巣固定術, 1例で精巣摘除術を行った.4例は自然整復例と判断された.健側の精巣固定は行わなかったが, 再発はみていない

We experienced fifteen cases of torsion of the spermatic cord during the past 10 years. The age distribution was from 10 to 40 years old and the average age was 21.1 years. All cases except one case of right undescended testis occurred on the left side. To our interest, the onset in 12 of the 13 cases with known onset time were during sleep or within one hour after waking up. All cases except one case in the undescended testis complained of pain of the testis and some of them were accompanied with pain in the inguinal and lower abdominal region. Swelling and tenderness of the testis were observed in most cases and shortness of the spermatic cord probably caused by torsion and secondary inflammation seemed to be important findings. Prehn's sign and fever up were observed in few cases but leukocytosis was seen in 10 cases. Eleven cases of surgical treatment consisting of 10 orchiopexy and one orchiectomy were performed. Four cases of spontaneous detorsion were included in our experience. Orchiopexy of the contralateral intact testis was not done, but, we have never experienced relapse of torsion.