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A retrospective multicentric analysis on testicular torsion: is there still something to learn?
- Source :
- European Urology Open Science, Vol 19, Iss, Pp e2078-(2020)
- Publication Year :
- 2021
-
Abstract
- Introduction and aim: Speedy diagnosis are mandatory in testicular torsion, nevertheless some cases of irreversible ischemia still occur. In this study we analysed the results of patients undergoing surgical exploration for acute scrotum. Materials and methods: A multicentric retrospective clinical evaluation was carried out on patients who underwent urgent scrotal exploration at 12 different departments in North-Eastern Italy. Data included complete anagraphic information, clinical presentation, numeric pain rating scale, previous testicular surgery, Doppler serial ultrasonography (US) evaluation and concordance with surgical findings, testicular mobility, surgical treatment, staged or concurrent treatment of the contralateral gonad. Statistical analysis was conducted both for descriptive and inferential statistics with SPSS v26. Results: Three hundred and sixty-eight cases were collected between January 2010 and June 2019. The time between symptom onset and ER access time was within 6 h in majority of patients. However, 17.4% of subject presented after more than 12 h. In patients undergoing US, this showed signs of ischemia in 237 patients (77.2%) and normal vascularisation in 70 (22.8%) of whom 26 had signs of testicular torsion at surgical exploration. Overall, the US data were concordant with the surgical findings in 254 cases (82.7%). A significant association was found between time-to-evaluation and time-to-treatment and the need for orchiectomy (p < 0.01). Conclusion: Testicular torsion management is still challenging in terms of time-saving decision making. Scrotal US is helpful, but even in the contemporary its sensitivity is low era in a non-neglectable number of cases, therefore surgical exploration is warranted in acute scrotum when torsion cannot be ruled out, even when US shows vascularisation.
- Subjects :
- Male
medicine.medical_specialty
Urology
Acute scrotum
030232 urology & nephrology
Ischemia
Testicular pain
030204 cardiovascular system & hematology
lcsh:RC870-923
lcsh:RC254-282
03 medical and health sciences
0302 clinical medicine
Testis
medicine
Epididymo orchitis
Testicular torsion
surgical exploration
Humans
epididymo-orchiti
Retrospective Studies
Spermatic Cord Torsion
business.industry
General surgery
lcsh:Diseases of the genitourinary system. Urology
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
medicine.disease
testicular torsion
Surgery
Nephrology
testicular pain
Scrotum
epididymo-orchitis
medicine.symptom
business
Orchiectomy
Subjects
Details
- ISSN :
- 21681813
- Volume :
- 55
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Scandinavian journal of urology
- Accession number :
- edsair.doi.dedup.....d499725af185e69e442364da407cc41d