Effectiveness of Treatment of Testicular Torsion by CentralAsianStudies

CENTRAL ASIAN JOURNAL OF MEDICAL AND NATURAL SCIENCES Volume: 03 Issue: 05 | Sep-Oct 2022 ISSN: 2660-4159 http://cajmns.centralasianstudies.org

Effectiveness of Treatment of Testicular Torsion 1. Toshev Suxrob Uktamovich 2. Supkhonov Umar Umedovich

Received 28th Aug 2022, Accepted 29th Sep 2022, Online 31st Oct 2022

Samarkand State Medical University Department of Skin and Venereal Diseases Samarkand, Uzbekistan

Abstract: This article summarizes the study Studied 48 patients with testicular torsion in patients older than eighteen years. A retrospective analysis of medical records of inpatients was carried out. The task of our work included the assessment of the occurrence of the disease in different age groups, the analysis and systematization of data on the time patients sought medical care from the onset of the disease, the tactics and immediate results of the treatment of testicular torsion. Key words: treatment, testicular torsion.

Student of Samarkand State Medical University, Samarkand, Uzbekistan

Introduction. Testicular torsion is an acute pathological condition in which the testicle rotates around a vertical or horizontal axis by more than 180°, leading to impaired testicular blood flow due to pathological mobility of the scrotum organs. Acute ischemia, if it is not resolved, leads to gonadal necrosis. In this case, the hematotesticular barrier is destroyed, the formation of autoantibodies occurs, which affect the remaining testicle, i.e. autoimmune inflammation occurs, after which infertility develops. Fertility disorder has not only medical but also social significance. This disease occurs most often in pediatric practice (the peak incidence occurs at the age of 13-14 years). However, according to J.H. Barada et al. (1989), the incidence of this pathology is 1/4000 in men under 25 years of age. And J.Zerin et al. (1989) note an anatomical predisposition to testicular torsion in 1 out of 160 males under 25 years of age. According to a retrospective analysis by J.M. Cummings et al. (2002) of patients with testicular torsion over 9 years found that out of 44, 17 were older than 21 years. Therefore, this pathology was investigated in patients older than eighteen years. Among the main factors that can cause the development of testicular torsion, the following are noted: Pathological testicular mobility. It can be caused by underdevelopment of Gunter's ligament (which normally fixes the testicle to the bottom of the scrotum) or various intrauterine disorders in the formation of the vaginal process of the peritoneum: this disrupts the development of mesorchia (mesentery of the testicle, which normally fixes it to the walls of the scrotum), and the testicle acquires additional mobility according to the "tongue of the bell". Sharp contractions of the scrotum and the muscle that lifts the testicle (which is possible with injuries, sudden movements, sudden tension of the abdominal muscles, masturbation, persistent coughing). However, it is not uncommon for the testicle to twist during sleep. One of the predisposing factors for the development of testicular torsion is also wearing tight clothing.

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Copyright (c) 2022 Author (s). This is an open-access article distributed under the terms of Creative Commons Attribution License (CC BY).To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/

CAJMNS

Volume: 03 Issue: 05 | Sep-Oct 2022

Objective: to assess the occurrence of the disease in different age groups, to analyze and systematize data on the time patients seek medical care from the onset of the disease, tactics and immediate results of treatment of testicular torsion. To study the age structure of patients with testicular torsion. Analyze the time interval of patients' treatment. Assess the immediate results of treatment. Materials and methods. We studied 48 patients with testicular torsion in patients over eighteen years of age. A retrospective analysis of medical records of inpatients was carried out. To determine the type of torsion and its degree, the following classification was used. Anatomical: 1) extravaginal torsion, 2) intravaginal torsion, 3) testicular torsion relative to the epididymis (4). By degree: incomplete torsion (180-360°); complete testicular torsion: 1st degree - 360-450°; 2nd degree - 450-720 °; 3rd degree more - 720° (2). In the diagnosis of torsion, complaints were assessed, an anamnesis was taken, a physical examination was performed (attention was paid to the positive symptom of Pren and the absence of a cremaster reflex), ultrasound, general and biochemical blood tests, and a general urine test. Results and discussions. All patients had intravaginal testicular torsion. In pediatric practice, there is extravaginal and torsion of the testicle relative to the epididymis (7), which is casuistry for adult patients. Torsion of the right testicle occurred in 26 (54.2%) patients, and the left - in 22 (45.8%), although according to the literature data, torsion of the left testicle is more common. At the same time, incomplete torsion was diagnosed in 28 (58.3%) patients, complete torsion - in 20 (41.7%) patients: 1st degree - 13 (65%); 2nd degree - 4 (20%); 3rd degree - 3 (15%). The study established the following age structure of patients with the disease: 1) 18 - 20 years - 16 patients (33.3%); 2) 21 - 30 years - 23 patients (47.9%); 3) 31 - 40 years - 6 patients (12.5%); 4) 41 - 50 years - 2 patients (4.2%); 5) 51 - 60 years - 1 patient (2.1%); According to the data obtained, the highest incidence of this pathology occurs in men aged 18–30 years - 39 patients ((81.2%) cases). Changes in the general blood test were noted in 28 individuals: leukocytosis over 10,000 per µl. An increase in body temperature (more than 37 ° C) - in 6 people. Treatment: 9 (18.75%) patients underwent effective manual testicular detorsion. Subsequently, 4 patients underwent elective orchiopexy. Surgical treatment was carried out in 39 (81.25%) cases, while in 37 patients (94.9%) it was carried out in the first 6 hours after admission to the hospital. The indication for surgical treatment was the diagnosis of testicular torsion established at admission in 21 patients, and in 18 patients torsion could not be excluded. Surgical treatment consisted of revision of the scrotum organs with subsequent detorsion of the gonad; if it was viable, orchiopexy was performed, and in case of necrosis, testectomy was performed (in 9 patients (18.8%)). It should be noted that 8 patients with necrosis sought medical help on the 2nd day and later from the onset of the disease. As a result of the study, there is a clear relationship between the death of the gonad, which directly depends on the degree of torsion: 8 patients had complete torsion, one had incomplete torsion, as well as on the time of seeking medical help from the onset of the disease. 28 (58.3%) patients applied on the first day of the disease. Orchidopexy of the contralateral testicle for prophylactic purposes was performed in 2 cases. The average length of stay in the hospital was 4 days. An increase in body temperature (more than 37 °C) after surgery was observed in 5 patients. Conclusions: Testicular torsion in patients over 18 years of age most often occurs at the age of 18-30 years (39 patients (81.2%)). Only 28 (58.3%) patients applied on the first day from the onset of the

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CAJMNS

Volume: 03 Issue: 05 | Sep-Oct 2022

disease, when it is possible to obtain a good result of treatment. In 9 (18.8%) patients, testicular necrosis was detected, which led to its removal, while the development of necrosis depends on the degree of torsion and timely treatment started. Literature: 1. Iskandarovna K. M., Alamovich K. A., Rabbimovich N. A. Treatment of Urethrogenic Prostatitis Associated with Chlamydia Infection //TA'LIM VA RIVOJLANISH TAHLILI ONLAYN ILMIY JURNALI. – 2021. – Т. 1. – №. 5. – С. 44-46. 2. Iskandarovna K. M., Buribaevna I. S., Azamovna A. N. Immunoassay Forms of Syphilis //TA'LIM VA RIVOJLANISH TAHLILI ONLAYN ILMIY JURNALI. – 2021. – Т. 1. – №. 5. – С. 47-49. 3. Iskandarovna K. M. SIFILISNING IMMUNOASSAY SHAKLLARI //BARQARORLIK VA YETAKCHI TADQIQOTLAR ONLAYN ILMIY JURNALI. – 2022. – С. 534-536. 4. Toshev S. U. THE USE OF ADVANTAN IN THE LOCAL TREATMENT OF GENITAL HERPES //Asian journal of pharmaceutical and biological research. – 2022. – Т. 11. – №. 2. 5. Toshev S. U. APPLICATIONS OF ELACON FOR LICHEN PLANE //Asian journal of pharmaceutical and biological research. – 2022. – Т. 11. – №. 2. 6. Ахмедова М. М., Абдуллаев Д. М., Тошев С. У. ИСПОЛЬЗОВАНИЯ МАЗЬИКУРАЛИМУС ПРИ ЛЕЧЕНИИ КРАСНОГО ПЛОСКОГО ЛИШАЯ //BARQARORLIK VA YETAKCHI TADQIQOTLAR ONLAYN ILMIY JURNALI. – 2022. – Т. 2. – №. 3. – С. 191-193. 7. Тошев С. У., Сулаймонов А. Л., Тиллакобилов И. Б. ТЕРАПИЯ ВИТИЛИГО С ПРИМЕНЕНИЕМ ПОЛИОКСИДОНИЯ В СОЧЕТАНИИ С ЛЮКОДЕРМИНОМ //Высшая школа: научные исследования. – 2019. – С. 55-59. 8. Нарзикулов Р. М. и др. Новый подход в лечении витилиго //НАУЧНЫЕ ИССЛЕДОВАНИЯ. – 2019. – С. 60. 9. Абдуллаев Д. М., Тошев С. У., Толибов М. М. КОМПЛЕКСНЫЙ МЕТОД ЛЕЧЕНИЯ ВУЛЬГАРНЫХ УГРЕЙ //Актуальные аспекты медицинской деятельности. – 2021. – С. 254256. 10. Тошев С. У., Аширов З. Ф., Абдуллаев Х. Д. ЛЕЧЕНИЕ ВИТИЛИГО 308-нм ЭКСИМЕРНЫМ ЛАЗЕРОМ //Актуальные аспекты медицинской деятельности. – 2021. – С. 240-243. 11. Нарзикулов Р. и др. Принципы терапии у женщин больных гонореей ассоциированные иппп //Журнал вестник врача. – 2019. – Т. 1. – №. 1. – С. 99-102. 12. Rizaev J. A. et al. Medical and organizational measures to improve the provision of medical care in the dermatovenerology profile //International Journal of Current Research and Review. – 2020. – Т. 12. – №. 24. – С. 120-122.

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