Predictive Parameters of Testicular Salvage of Pediatric Testicular Torsion: A 6-Year Experience of a Single Center
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Purpose: We evaluated parameters associated with testicular salvage in boys with testicular torsion.Materials and Methods: During 2009-2014, 19 boys younger than 18 years old underwent emergency surgery for testicular torsion in our hospital. Age, chief complaint, laterality of the torsion, physical appearance, ultrasonographic results, duration between the onset of symptoms and hospital visit, duration between the onset of symptoms and start of surgery, intraoperative appearance, surgical method (orchiopexy or orchiectomy), and any postoperative complications were analyzed retrospectively. Cases were categorized according to salvageable testes (n=14) or unsalvageable testes (n=5) groups based on testes viability.Results: The mean age was not significantly different between the two groups. All patients were diagnosed using color Doppler ultrasonography of the scrotum. Six (42.9%) boys in the salvageable testes group and all five in the unsalvageable testes group were transferred from other clinics or hospitals (p=0.026). The mean duration between the onset of symptoms and hospital visit was 925 minutes in the salvageable testes group and 3,488 minutes in the unsalvageable testes group (p=0.042), and the mean duration between the onset of symptoms and start of surgery was 1,131 minutes in the salvageable testes group and 3,777 minutes in the unsalvageable testes group (p=0.042). Conclusions: There was a high possibility that orchiectomy was required if surgery was delayed. However, even when a boy is admitted to the hospital more than 24 hours after the onset of symptoms, the testis can still be viable provided the surgery is performed as quickly as possible.
Abstract
Purpose: We evaluated parameters associated with testicular salvage in boys with testicular torsion.Materials and Methods: During 2009-2014, 19 boys younger than 18 years old underwent emergency surgery for testicular torsion in our hospital. Age, chief complaint, laterality of the torsion, physical appearance, ultrasonographic results, duration between the onset of symptoms and hospital visit, duration between the onset of symptoms and start of surgery, intraoperative appearance, surgical method (orchiopexy or orchiectomy), and any postoperative complications were analyzed retrospectively. Cases were categorized according to salvageable testes (n=14) or unsalvageable testes (n=5) groups based on testes viability.Results: The mean age was not significantly different between the two groups. All patients were diagnosed using color Doppler ultrasonography of the scrotum. Six (42.9%) boys in the salvageable testes group and all five in the unsalvageable testes group were transferred from other clinics or hospitals (p=0.026). The mean duration between the onset of symptoms and hospital visit was 925 minutes in the salvageable testes group and 3,488 minutes in the unsalvageable testes group (p=0.042), and the mean duration between the onset of symptoms and start of surgery was 1,131 minutes in the salvageable testes group and 3,777 minutes in the unsalvageable testes group (p=0.042). Conclusions: There was a high possibility that orchiectomy was required if surgery was delayed. However, even when a boy is admitted to the hospital more than 24 hours after the onset of symptoms, the testis can still be viable provided the surgery is performed as quickly as possible.
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