Русский
Complications of the «acute scrotum syndrome» in children
DOI: https://dx.doi.org/10.18565/urology.2020.3.77-80
I.S. Shormanov, D.N. Shedrov, E.V. Morozov, M.V. Pisareva, D.Y. Garova
1) FGBOU VO Yaroslavl state medical university of the Ministry of Health of the Russian Federation, Yaroslavl, Russia; 2) GBUZ of Yaroslavl region «Regional clinical pediatric hospital», Yaroslavl, Russia
Aim. To establish causes of complications and repeated surgical procedures in patients with acute scrotal pathology during the short- and long-term follow-up.
Materials and methods. The treatment results of 3315 patients aged 0 to 18 years with various forms of acute scrotal pathology were analyzed.
Results. A total of 43 complications were documented, 32 of them required surgical intervention. The most common complication is testicular necrosis due to incorrect judgement of viability after torsion with performing an organ-preserving procedure, which is dictated by the surgeon’s desire to preserve a testicle. Such a decision is made without objective data and in all cases leads to repeated procedure due to testicular necrosis. Inappropriate surgical hemostasis is often associated with improper surgical technique and underestimation of inflammatory tissue changes. Purulent complications are the most common in acute epididymitis and are caused by the presence of an inflammatory focus in the scrotum. Wide revision of the scrotum in case of testicular appendage’s pathology is not justified, since the second appendage is rarely found, while the invasiveness of the procedure increases.
Conclusion. Complications were more common in the early postoperative period (88.4%). Purulent complications are directly dependent on the duration of the disease and are exacerbated by the secondary inflammatory process. Most of complications are treatable; performing of preventive measures helps to avoid them.
Materials and methods. The treatment results of 3315 patients aged 0 to 18 years with various forms of acute scrotal pathology were analyzed.
Results. A total of 43 complications were documented, 32 of them required surgical intervention. The most common complication is testicular necrosis due to incorrect judgement of viability after torsion with performing an organ-preserving procedure, which is dictated by the surgeon’s desire to preserve a testicle. Such a decision is made without objective data and in all cases leads to repeated procedure due to testicular necrosis. Inappropriate surgical hemostasis is often associated with improper surgical technique and underestimation of inflammatory tissue changes. Purulent complications are the most common in acute epididymitis and are caused by the presence of an inflammatory focus in the scrotum. Wide revision of the scrotum in case of testicular appendage’s pathology is not justified, since the second appendage is rarely found, while the invasiveness of the procedure increases.
Conclusion. Complications were more common in the early postoperative period (88.4%). Purulent complications are directly dependent on the duration of the disease and are exacerbated by the secondary inflammatory process. Most of complications are treatable; performing of preventive measures helps to avoid them.
About the Autors
Corresponding author: D.N. Shedrov – MD, Head of Department of Pediatric Urology and Andrology of GBUZ of Yaroslavl region «Regional clinical pediatric hospital», Yaroslavl, Russia; e-mail: shedrov.dmitry@yandex.ru
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