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Background: Cryptorchidism and testicular torsion (TT) are relatively common conditions in clinical practice; however, sparse information about cryptorchid TT is available in the current literature., Methods: We retrospectively reviewed the clinical characteristics, treatment modalities, and long-term outcomes of pediatric patients treated for acute cryptorchid TT., Results: We found eight patients with unilateral acute cryptorchid TT with a prevalence of 8.9% (8/90) among all TT cases. The left testis was affected in six patients. The median age of patients at the time of the surgery was 65 months (interquartile range (IQR) 4-136 months). The median duration of symptoms was 16 h (IQR 9-25 h), while the median time to treatment was 60 min (IQR 59-63 min). The most common symptoms were pain (abdominal and inguinal) and inguinal mass with no palpable testis in the ipsilateral hemiscrotum. Preoperative color Doppler ultrasonography revealed absent or decreased testicular blood flow in the affected testes in 7/8 of patients. Various degrees of testicular torsion (median 540°, min 360°, max 1260°) were found during surgery. A necrotic testis that led to orchidectomy was found in 4/8 of patients. The median follow-up period was 42.6 months (IQR 12.5-71.2 months), revealing only one patient with testicular atrophy. The final testicular salvage rate was 35%., Conclusions: Greater awareness among caregivers and primary care physicians about acute cryptorchid TT is required to improve their timely diagnosis and treatment. A physical examination of the external genitalia and inguinal regions should be mandatory to attain a proper diagnosis and treatment without delay., Competing Interests: Declaration of competing interest Una Glamoclija is an employee of Bosnalijek d.d., Sarajevo. Other authors do not have a conflict of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

We describe and summarize the diagnosis, treatment, and reasons for delayed treatment of children with cryptorchidism torsion in Children's Hospital of Chongqing Medical University. The study included 19 cases of cryptorchidism torsion. The age of the children ranged from 16 days to 12 years (median: 6 years). The interval from diagnosis to surgery varied from 4 h to 16 days (median: 3 days). Ultrasound was performed in all cases. Fifteen cases had cryptorchidism torsion, 2 cases had a soft tissue mass in the inguinal region, and 2 cases had an inguinal/abdominal teratoma. Five cases were treated with an orchidopexy, 12 cases were treated with orchiectomy, and 2 cases received resection of a testicular tumor. The 5 children with an orchidopexy were followed up from 1 month to 7 years (median: 3 years), with 1 child having a testis retraction and no blood supply. Of the 12 children who had an orchiectomy, three had delayed diagnosis due to family unawareness of the condition, while other delays were due to delayed referral from primary care facilities. The relative rarity and insufficient awareness of cryptorchidism torsion resulted in a low rate of testicular salvage. Therefore, hospitals of all levels should be fully aware of cryptorchidism with torsion and ensure a male child's genital system and inguinal region are examined to improve the success rate of testicular salvage., Competing Interests: None

Background: Cryptorchidism in dogs is of clinical concern due to its association with development of Sertoli cell tumours, seminomas and spermatic cord torsion. A patent inguinal ring has been found as a risk factor for peritoneal content migration and inguinal hernias. This study reports a case of bowel migration through a patent inguinal ring in a bilaterally cryptorchid dog and incarceration within the vaginal tunic of the left testicle., Case Presentation: A three-and-a-half-year-old bilaterally cryptorchid Lhasa Apso with a history of anorexia, vomiting, stranguria and inability to defecate was diagnosed with bowel incarceration in the vaginal tunic of a retained left testicle. Surgery performed under epidural anaesthesia with acepromazine/butorphanol premedication revealed a loop of the colon entrapped in the vaginal tunic of the retained left testicle. The incarcerated bowel was thoroughly examined for viability and repositioned into the abdominal cavity. The inguinal ring was repaired and bilateral cryptorchidectomy performed., Conclusion: Cryptorchidectomy in dogs is often considered when there is concern for neoplasm or torsion of retained testes. However, this report suggests that cryptorchidectomy should be considered also to preclude the possibility of bowel obstructive emergencies.

Testicular torsion is well-known urologic emergency. It warrants urgent diagnosis and surgical intervention for successful outcomes. The incidence of undescended testis in new born is 2%-8% and reduces to <1% by 1 year of age. In majority of cases, it is located in inguinal canal. Though undescended testis is a known risk factor for testicular torsion, there are limited cases reports in the literature. Testicular torsion in undescended testis is difficult to diagnose due to vague symptoms and absence of testicular signs. We report a unique case of testicular torsion in an inguinal undescended testis in a 14-year young male., (Copyright © 2020 Elsevier Inc. All rights reserved.)

The purpose of this study was to follow up patients who underwent testicular torsion orchiopexies in order to observe whether testicular atrophy had occurred and to identify any influencing factors regarding atrophy. Patient data collected in this study included age, symptom duration, pre-operative preparation time, cryptorchidism testicular torsion, spermatic cord torsion degree, ultrasound findings at least 6 months after orchiopexy, testicular atrophy, mean platelet volume (MPV), address and medical insurance. Twenty-nine patients with a mean age of 147 (126.5-163) months involved in our study. The duration of follow-up ranged from 6 to 33 months with a median follow-up duration of 12 (8.5-21) months. Only MPV was significantly different between the atrophy group and nonatrophic group (p = .022) and the receiver operating characteristic (ROC) curve revealed that the cut-off value for MPV atrophy was 9.9 fl, with a sensitivity of 81.8% and a specificity of 70.6%. In conclusion, we found that 41.4% patients eventually experienced testicular atrophy after performing the testicular salvage procedure. MPV might be used as an indicator of testicular atrophy after an operation; however, the accuracy of MPV needs to be confirmed using significant follow-up prospective studies., (© 2019 Blackwell Verlag GmbH.)

The purpose of this study was to evaluate the predictive value of haematologic parameters for testicular survival in torsion. Children with testicular torsion (TT) treated in Beijing Children's Hospital from January 2006 to December 2018 were enrolled in this study. Patient data collected in this study included age, symptom duration, preoperative preparation time, cryptorchidism testicular torsion or not, spermatic cord torsion degree, orchiectomy/orchiopexy, testicular volume 3 months after operation by ultrasound in orchiopexy patients and haematologic parameters. The orchiopexy group comprised of 54 patients with a mean age of 135.6 ± 43.73 months, and the orchiectomy group included 58 patients with a mean age of 119.36 ± 60.82 months. The multivariate analysis showed that symptom duration (Odds Ratio = 1.11, p < 0.001), spermatic cord torsion degree (Odds Ratio = 1.006, p = 0.002) and mean platelet volume (MPV; Odds Ratio = 3.697, p = 0.044) were significant predictors of orchiectomy. The cut-off value for MPV during window time for orchiectomy was 10.55 fl (10 -9  L) and provided a sensitivity of 47.8% and a specificity of 92.6%. This study found that symptom duration, spermatic cord torsion degree and MPV could be indicators of testicular viability in testicular torsion. MPV can provide valuable information before operation which can guide doctors and family members of the patients to select the appropriate treatment., (© 2019 Blackwell Verlag GmbH.)

A 39-year-old man presented with a 2-day history of worsening constant, dull diffuse lower abdominal pain with associated constipation and known history of left undescended testicle. He was evaluated at an outside hospital where a non-contrasted CT scan revealed a 20 cm well-circumscribed soft tissue mass within the pelvis.He was referred and further imaging revealed a 12 cm heterogeneous mass with foci of air that appeared to be contiguous with the left spermatic cord. This constellation of findings could represent torsion of undescended left testicle with infarction or underlying malignancy. Tumour markers were only significant for elevated lactate dehydrogenase of 1445. A subsequent ultrasound-guided biopsy of the mass demonstrated seminoma.Surgical resection revealed a large intra-abdominal mass emanating from the left spermatic cord with 270° of torsion. There appeared to be a left atrophic remnant testicle at the base of the mass with final pathology confirming the diagnosis of classic seminoma., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Objective: The aim of this study was to compare the computed tomography imaging features of a torsed inguinal testis with nontorsed inguinal testes., Methods: Computed tomography scans of patients with undescended testes were retrospectively collected (2011-2016). Imaging features of nontorsed undescended testis were compared with a case of an inguinal torsed testis. Observations included location of the undescended testis, size (length × width) and texture of each testis, peritesticular findings, position of testicular vessels, and enhancement patterns., Results: Twelve nontorsed inguinal undescended testes were compared with 1 torsed undescended testicle. Torsed testis was larger than nontorsed (44 × 27 mm vs 32.9 ± 6.1 × 22.9 ± 4.9 mm), surrounded by fat stranding and fluid, with heterogeneous texture, enhancement of its outer layers, and an upward kink of its vessels., Conclusions: Because torsed undescended testis can mimic a groin abscess and because torsion is a medical emergency, radiologists should be aware of this entity and its distinguishing imaging features. Color Doppler examination can ascertain absence/reduction of blood flow.

We reported a case of torsion of the undescended testis in a 9-month-old boy which was diagnosed with 99mTc testicular scin-tigraphy. The scan showed diffuse increased activity in the location of the undescended testis and no photopenic area was visible. At surgery, torsion of the undescended testis was detected and fixed.

Histologically confirmed polyorchidism is an uncommon condition. The majority of cases are asymptomatic and associated with inguinal hernia or cryptorchidism. There are few reported cases of pediatric supernumerary testis presenting with testicular torsion. We present a case of missed torsion with incidentally detected triorchidism as well as an overview of pediatric polyorchidism.

Torsion of the testis is a true surgical emergency in paediatric age group. Prompt recognition of the condition and immediate surgical intervention is the only hope for testicular salvage. The condition becomes all the more important when this occurs in an undescended testis as the diagnosis is often delayed, and therefore the treatment too. A six-month old infant presented with the torsion of an undescended testis. Even prompt exploration could not avoid the necrosis and orchidectomy was done. Therefore to avoid this almost unsalvageable condition the orchiopexy must be considered at an earlier age.

A 47-year-old man visited our hospital suffering from intensive pain of the swelling mass in his left inguinal region. He had never recognized the left testis in his scrotum, and felt the left inguinal mass growing slowly since a year ago. Computed tomography and Doppler uitrasonography revealed a mass approximately 5 cm in diameter separating from intestines in the abdominal cavity and not supplied sufficient blood flow. We suspected that the mass was a testicular cancer in cryptorchidism with testicular torsion and performed orchiectomy. At the time of the operation, the mass and the spermatic cord were twisted and prolapsed out of the aponeurosis of external abdominal oblique muscle. Histopathologically, malignant degeneration was demonstrated in the undescended testis, and the cell type was seminoma. We definitely diagnosed the mass as torsion of a testicular cancer in cryptorchidism prolapsing out of the inguinal canal.

We describe a rare case of right testicular necrosis and left vanishing testis in a neonate. The patient presented with a right swollen testis and left non-palpable testis at birth. Exploratory laparotomy was performed at 23 days after birth, and the right testis was extirpated because of extensive necrosis due to torsion of the spermatic cord. Histopathological examination revealed a massively necrotic testicular structure with hypertrophy of Leydig cells. Hypergonadotropinemia was also recognized before operation. On laparoscopy at the age of 5.3 years, a normal left vas deferens and spermatic vessels exiting through the internal inguinal ring were confirmed, although the patient's left testis was not found in the intraperitoneal cavity. An hCG test demonstrated no response of serum testosterone. These findings suggested a diagnosis of left vanishing testis due to testicular regression. We therefore speculated that bilateral asynchronous testicular torsion had occurred prenatally in this patient.

Torsion of a cryptorchidid testicle presents a non-specific symptomatology. Clinical suspicion indicates surgical exploration, irrespective of Doppler ultrasound with its inherent false negative results. With regards to treatment, an orchiectomy is performed when the testis is necrotic. Management of the contralateral testis is controversial. Our policy is not to fix them systematically because we believe that a healthy education of parents and children is more important, so as to obtain an earlier diagnosis of a future torsion.

Purpose: The literature concerning undescended testis mainly concentrates on the increased risks of infertility and development of germ cell tumors. Yet the UDT also appears to be at higher risk for torsion compared to the normally descended testis, and this issue is relatively poorly addressed. We reviewed all cases of torsion of UDTs operated on at our hospital during the last 20 years in an attempt to characterize better this condition and its salvageability., Materials and Methods: In this retrospective clinical study we reviewed and analyzed all cases of testicular torsion involving UDT operated on at our hospital between 1984 and 2004., Results: A total of 11 children were operated on at our hospital for torsion of undescended testis between 1984 and 2004. Patient age ranged from 1 month to 18 years (median 7.5 months). In all cases unilateral torsion of undescended testis was diagnosed, with 73% of cases involving the left side. Clinical symptoms included inguinal swelling and erythema associated with a tender, firm mass palpated in the groin area and an empty ipsilateral hemiscrotum. Doppler ultrasound examination was routinely performed in the last 7 patients to confirm the diagnosis. During inguinoscrotal exploration severe ischemia or overt necrosis of the testis was found in 5 of 11 cases. Three of these 5 cases were managed by orchiectomy, while in the other 2 cases the testis subsequently vanished. In the 6 patients who exhibited some improvement following detorsion and warming of the tissue the testes were preserved and orchiopexy was performed. Followup was available in only 5 patients, with vanishing of the torsed testis observed in 4 and a normal testicle detected 21 years postoperatively in 1 patient who was diagnosed early., Conclusions: This series clearly demonstrates poor rates of surgical salvage, which we mainly attribute to delays in parental response and in primary physician referral to the hospital. Parents, who have a pivotal role in early diagnosis, were usually unaware of this urological emergency, and some were surprisingly unaware of the presence of cryptorchidism. By increasing the awareness regarding this entity among members of the medical community and parents, we hope that torsion of the cryptorchid testis (literally, "hidden testis") will no longer necessarily be synonymous with "crypt-torsion" ("hidden torsion").

We report a case of testicular torsion in the left inguinal canal of a 7 month old with a history of cryptorchism and no evidence of neuromuscular disease. We discuss the pathophysiological mechanisms, sonographic findings, and treatment of this rare entity.

Undescended testis is one of the most common disorders in Down's syndrome. We present an extremely rare case of torsion of an inguinal undescended testis in a 35-year-old patient with Down's syndrome. Surgical exploration revealed a rotated gangrenous testis, radical orchiectomy was performed, and pathological examination confirmed the diagnosis of testicular torsion.

An undescended, cryptorchid testis is predisposed to 3 to 40 times risk of malignancy. Torsion of a cryptorchid testis is more difficult to diagnose than a normally placed testis. We present a case of a 25-year-old man with acute abdomen due to the torsion of an intra-abdominal testis. Subsequent histopathology of the testis revealed seminoma, making this single testis the seat for triple pathology. Orchidectomy was done followed by radiotherapy. A follow-up of upto nine months showed no recurrence or metastases.

Torsion of an intraabdominal testis is a rare cause of acute abdominal pain. With a history of undescended testis, it is difficult to establish the diagnosis and to exclude other emergency abdominal conditions without a laparotomy. The following case report illustrates the usefulness of laparoscopy as a diagnostic as well as a therapeutic tool in such a condition.

Earlier, the cause of infertility in undescended testis (UT) had been widely accepted as a consequence of the higher temperature of the inguinal/abdominal region. Observations made in the past two decades, however, gave new evidences. The most important of these is that UT is often associated with the fusional anomalies (FA) of the testis and epididymis. FA is the consequence of pathological intrauterine hormonal processes and many authors believe FA to be the primary cause for infertility in UT. Since 80% of UT cases are of endocrine origin, it would be suspected that the very same factors are responsible for both UT and FA. FA and other anomalies of the epididymis often occur in testicular torsion (TT) as well. It is remarkable that infertility could follow the unilateral forms of UT and TT despite the presence of a "healthy" contralateral gonad. In both entities contralateral FA (probably associated with testicular dysgenesis) is suspected. These observations could influence the primary surgical treatment of patients with UT and TT, as well as the mode of further management of these cases.

The thirty-ninth reported case of torsion of an intra-abdominal testicle is described in a neonate. The gonad was excised as is recommended because of the high incidence of malignancy (60% of 37 cases). Torsion of an intra-abdominal testicle should be considered where an abdominal mass with calcification is found in an infant with undescended testis. Ultrasonography improves the diagnostic accuracy in infants because of the cystic nature of these masses in this age group.

A 5-year-old Quarter Horse stallion was admitted for cryptorchidectomy. Abnormalities were not found on physical examination, except for an undescended left testis. Cryptorchidectomy was performed, using an inguinal approach. The tail of the epididymis was in the inguinal canal, and the testis was adjacent to the internal inguinal ring. The testis was dark reddish purple to black, resulting from torsion at the level of the body of the epididymis. On histologic examination, the left testis was necrotic, except for the tunica albuginea and tunica vaginalis visceralis covering the testis. Intra-abdominal testicular torsion developed without signs of abdominal pain and resulted in necrosis of the affected testis. If cryptorchidectomy had not been performed, it is likely that the horse would have been found to be monorchid. Unrecognized intra-abdominal testicular torsion may be the cause of monorchidism in some horses.

We report a case of intravaginal testicular torsion with an unusual debut in a 30 day old patient which had undescended testis. We emphasize the need of a complete physical exploration of the child that go to the emergency service with inspecific symptoms of abdominal pain, and supposing the hemiscrotum was empty, is essential to reject a torsion of a cryptorchidic testicle. An immediate surgery is necessary in order to diagnose and treat this disturbance.

It has been suggested that the most likely cause of the Testicular Regression Syndrome (TRS) is ante-natal torsion of the testis. As testicular torsion is twice as common on the left this theory cannot explain the incidence of right sided or bilateral cases. From a 5-year retrospective surgical and pathological review, we confirmed that the left testis was the most commonly affected, that boys with TRS tended to be delivered closer to term, and that frequently both testes were present at birth, but one or both subsequently vanished. We also found that direct trauma can produce histological findings indistinguishable from TRS. Close to term, fetal testes are liable to be intrascrotal and therefore susceptible to direct trauma. As the left testis descends into the scrotum at an earlier stage than the right, it is therefore at greater risk of injury. Since the findings of TRS can be produced by direct trauma, we suggest that intra-partum trauma may predispose to the TRS.

Two adult horses had colic attributable to spermatic cord torsion and strangulation of abdominally retained neoplastic testes. Both horses had caudal abdominal soft tissue masses palpable per rectum. One horse was treated successfully by surgical removal of the testis, and the other was euthanatized without treatment. Histopathologic diagnosis of the involved testes was testicular seminoma. Spermatic cord torsion of an abdominally retained testis should be considered in the differential diagnosis of signs of abdominal pain in cryptorchid stallions, especially those with a palpable caudal abdominal mass.

Torsion of an intraabdominal testicular tumor is a rare preoperative diagnosis. An increased diagnostic yield is dependent on an expedient and comprehensive preoperative evaluation. This consists of a detailed past surgical history, a thorough physical examination, and close inspection of the preoperative abdominal films. An illustrated case report is presented.

Intra-abdominal torsion of an undescended testis is a rare surgical problem in the neonate. However, one must consider the possibility of intrauterine torsion in a neonate who presents with an undescended testis and an abdominal mass.

An eight-year-old boy was admitted to our hospital with the chief complaint of pain and swelling of the left inguinal testicle which had occurred 4 days earlier. Surgical findings revealed 180 degrees clockwise rotation of the testicle, and necrosis of the testicle and epididymis, and then left orchidectomy was performed. The post-operative diagnosis was torsion of the undescended testicle with hemorrhagic infarction. We discussed on the pre-operative diagnosis and the treatment of this disease.

In two patients with cryptorchism orchidectomy was performed because of testicular atrophy and torsion respectively. From the macroscopic appearance malignancy was not expected in either of the cases, but histological examination showed invasive carcinoma. This indicates that biopsies should be taken whenever operations are performed on cryptorchid testes, and it may be of importance to biopt all cryptorchid testes at a certain age.

A 15-year-old boy was consulted to our hospital with the complaint of swelling of the left inguinal region with tenderness. Under the diagnosis of torsion of the undescended testicle, left orchidopexy was done with the finding of left testicle which had 360 degree counterclockwise intravaginal rotation. This was thought to be the 54th case of the disease in Japan. We have made some discussion on incidence, complication, diagnosis and therapy.

A 17-year-old boy with spastic quadriplegia presented with a progressively enlarging, tender, right inguinal mass. Examination revealed absence of both testicles in the scrotal sac. The left testicle was palpable in the left superficial inguinal pouch. A diagnosis of an undescended right testicle was confirmed by exploratory surgery. Orchidectomy of the right testicle was performed and the remainder of the patient's course was uneventful. We present this case to describe the relationship between cryptorchidism, testicular torsion, and neuromuscular disease. Specific emphasis is placed on incidence, pathophysiological mechanisms, and treatment of testicular torsion in cryptorchidism.