Duration of symptoms is the only predictor of testicular salvage following testicular torsion in children: A case-control study

Am J Emerg Med. 2021 Mar:41:197-200. doi: 10.1016/j.ajem.2020.11.023. Epub 2020 Nov 15.

Abstract

Objective: Testicular torsion (TT) is an emergency requiring a prompt diagnosis and surgery to avoid irreversible changes and a complete loss of testis. The present study aimed to identify potential factors that may be predict a testicular salvage after TT in pediatric patients.

Methods: Consecutive medical records of all children ≤16 years old with surgically confirmed TT over a period of five years (2011-2016) were collected. Patients were divided into 2 groups according to testicular viability and the type of treatment: Orchidectomy and orchidopexy. The differences between the two groups and potential predictors of testicular salvage were analyzed.

Results: Thirty-one boys with TT met the inclusion criteria and were included in the study. The mean age was 13.6 years (range, 10 days - 15.8 years). Testicular salvage was possible in 18 (58.1%) patients. The duration of symptoms and a lesser degree of torsion indicated a testicular salvage in children and adolescents with testicular torsion, but in multivariate analysis only duration of symptoms (time to surgical detorsion) was significantly associated with the risk of non-salvage. At follow-up, testicular atrophy affected 73.3% of the patients treated with orchidopexy.

Conclusion: Duration of symptoms is the only predictor of successful testicular salvage following testicular torsion in children. It is associated with a substantial risk of testicular loss and atrophy.

Keywords: Children; Predictive factors; Testicular salvage; Testicular torsion.

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Orchiectomy*
  • Orchiopexy*
  • Prognosis
  • Spermatic Cord Torsion / diagnosis
  • Spermatic Cord Torsion / surgery*
  • Symptom Assessment
  • Time Factors