SUCCESSFUL PRESERVATION OF TORSED TESTICLE USING TUNICA ALBUGINEA INCISION: REPORT OF TWO CASES

Testicular torsion is a condition of ischemia due to blood flow disturbance, ischemia-reperfusion injury after the detorsion, and compartment syndrome with increased intratesticular pressure. If no improvement in testicular color and appearance is noted after the detorsion, the tunica albuginea incision can be performed to preserve the testis. Case 1: A 13-year-old male came to our hospital with left scrotal pain, and emergency surgery was performed six hours after the onset with the diagnosis of left testicular torsion. The left testis was externally rotated 180 degrees, and the testis remained poorly colored after the detorsion. The testicular color improved after the tunica albuginea incision. The defect of the albuginea was covered with a tunica vaginalis flap. One year after the operation, testicular size remained the same, and blood flow in the left testis was good. Case 2: A 16-year-old male came to our hospital with right scrotal pain, and emergency surgery was performed 10 hours after the onset with a diagnosis of right testicular torsion. The right testicle was internally rotated 180 degrees, and the testis remained poorly colored after the detorsion. The tunica albuginea incision was performed and covered with a tunica vaginalis flap after improvement of color. Six months after the operation, testicular size remained the same, and blood flow in the right testis was good. Testicular preservation was possible with tunica albuginea incision and tunica vaginalis flap for testicular torsion. However, the long-term effect of these techniques on testicular function is unclear, and long-term follow-up is likely to be necessary.