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Long-term impact of testicular torsion and its salvage on semen parameters and gonadal function.

Authors :
Aggarwal D
Parmar K
Sharma AP
Tyagi S
Kumar S
Singh SK
Gupta S
Source :
Indian journal of urology : IJU : journal of the Urological Society of India [Indian J Urol] 2022 Apr-Jun; Vol. 38 (2), pp. 135-139. Date of Electronic Publication: 2022 Apr 01.
Publication Year :
2022

Abstract

Introduction: Testicular torsion is a urological emergency, and long-term outcomes of testicular torsion on infertility, hormonal function, and salvaged testicular size are unclear.<br />Materials and Methods: We conducted an ambispective, observational study from January 2014 to December 2019. Baseline demographics, time of presentation, clinical features, and management details of all the patients of testicular torsion were recorded from the database. All the patients were followed up in the outpatient clinic for testicular size, hormone levels, semen analysis, and erectile function.<br />Results: Of 85 patients, only 67 could be contacted and included in the final analysis. Group 1(orchiectomy) comprised 44 patients, and Group 2(salvage) had 23 patients. Follow-up duration ranged from 2 to 6 years and mean follow-up was 42 ± 12 months. The median time to presentation was significantly higher in Group 1 (48 hours) as compared to Group 2 (12 hours). The rate of testicular salvage did not vary with age of the patients. Doppler ultrasonography of the scrotum detected 92.5% of all cases of torsion. Antisperm antibody levels were within normal range in all patients. Approximately 47% of patients in the salvage group developed testicular atrophy on follow-up. Serum testosterone level was significantly lower in Group 1 and the subset of patients with testicular atrophy. Rest of the hormonal parameters, semen analysis, and erectile function were comparable between two groups.<br />Conclusion: The time between onset and presentation is an important contributing factor in guiding testicular salvage. Even after salvage, many testes may atrophy on follow-up. Orchiectomy and testicular atrophy in the long term have negative impact on serum testosterone. The patients should be counseled for a long-term follow-up for the risk of testicular atrophy and low testosterone levels.<br />Competing Interests: Conflicts of interest: There are no conflicts of interest.<br /> (Copyright: © 2022 Indian Journal of Urology.)

Details

Language :
English
ISSN :
0970-1591
Volume :
38
Issue :
2
Database :
MEDLINE
Journal :
Indian journal of urology : IJU : journal of the Urological Society of India
Publication Type :
Academic Journal
Accession number :
35400863
Full Text :
https://doi.org/10.4103/iju.iju_328_21