Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2023; 11(18): 4306-4312
Published online Jun 26, 2023. doi: 10.12998/wjcc.v11.i18.4306
Collagen fleece (Tachosil®) for treating testis torsion: A case report
Ki Min Kim, Jae Heon Kim
Ki Min Kim, Jae Heon Kim, Department of Urology, Soonchunhayng University Seoul Hospital, Seoul 04410, South Korea
Author contributions: Kim KM contributed to manuscript writing and data collection; Kim JH contributed to editing, conceptualization and supervision; All authors have read and approved the final manuscript.
Supported by The Soonchunhyang University Research Fund, No. 20230029.
Informed consent statement: We got a consent of this case report and any accompanying images from patient’s father.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read CARE Checklist (2016), and the manuscript was prepared and revised according to CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jae Heon Kim, Doctor, Professor, Department of Urology, Soonchunhayng University Seoul Hospital, 59 Daesagwanro, Yongsangu, Seoul 04410, South Korea. piacekjh@hanmail.net
Received: January 15, 2023
Peer-review started: January 15, 2023
First decision: February 28, 2023
Revised: March 13, 2023
Accepted: April 14, 2023
Article in press: April 14, 2023
Published online: June 26, 2023
Processing time: 162 Days and 14.9 Hours
Abstract
BACKGROUND

Testicular torsion is an emergent disease in urology, and there has been discussion of the treatment of testicular torsion. Testicular decompression has been established as a critical treatment for testicular compartment syndrome (TCS), which occurs after detorsion in a patient who is diagnosed with testis torsion. Until now, testicular fasciotomy and incision of tunica albuginea with tunica vaginalis flap (TVF) graft have been suggested for decompression, and some studies about the efficacy of TVF were reported. However, this method is time consuming and needs meticulous technique, so other methods such as orchio-septopexy are suggested. The objective of this clinical case report was to propose new surgical method using collagen fleece (Tachosil®) instead of tunica vagina flap.

CASE SUMMARY

A 5-year-old boy with scrotal pain visited our hospital 24 h after symptom onset. After history taking, physical examination, and scrotum ultrasonography, he was diagnosed with testis torsion. Emergency surgery was performed after diagnosis. Following the incision of scrotum and fasciotomy, we covered his tunica albuginea with collagen fleece called Tachosil® instead of covering with TVF.

CONCLUSION

Short-term follow-up showed normal blood flow in testis without a TCS. This is the first case report of using Tachosil® in testicular torsion surgery, and its advantages were already reported in other surgeries like Peyronie’s disease. Our case suggests this new technique is an appropriate method because of its advantages including its cost-effective and time-saving characteristics. The main limitation is the short follow-up, so more studies are needed to provide a high level of evidence about its efficacy and safety.

Keywords: Testicular torsion; Testicular compartment syndrome; Collagen fleece; Tachosil®; Case report

Core Tip: Testicular torsion is an emergent disease in urology that should be treated as quickly as possible. Its treatment is detorsion and orchiopexy. But fasciotomy has been suggested because this treatment is effective for testicular decompression, and it could prevent testicular compartment syndrome. Fasciotomy with tunica vaginalis flap coverage has been reported. Now, we suggest a new method with collagen fleece.