Optical diagnosis of testicular torsion: feasibility and methodology


Background: Torsion of the testis compromises blood flow through the spermatic cord; testicular ischemia results which if not diagnosed promptly and corrected surgically irrevocably damages the testis. Current diagnostic modalities aimed at rationalizing surgical exploration by demonstrating interruption of spermatic cord blood flow or testicular ischemia have limited applicability. Near infrared spectroscopy (NIRS) offers a non-invasive optical method for detection of ischemia; continuous wave and frequency domain devices have been used experimentally; no device customized for clinical use has been designed. Methods: A miniature spatially resolved NIRS device with light emitting diode light source was applied over the right and left spermatic cord and the difference in oxygen saturation between the two sides measured. Results: In a 14-month old boy with a history of unilateral testicular pain color Doppler ultrasonography was equivocal but the NIRS-derived tissue oxygen saturation index (TSI) was significantly reduced on the left side. Confirmation of torsion of the left testicle was made surgically. Conclusions: Spatially resolved NIRS monitoring of spermatic cord oxygen saturation is feasible in children, adding to prior studies of testicular oxygen saturation in adults. Customized device design and further clinical trials would enhance the applicability of NIRS as a diagnostic entity for torsion. © 2014 SPIE.

Photonic Therapeutics and Diagnostics X