OBJECTIVE: To test the clinical and sonographic predictors of testicular torsion (TT) with the aim of reducing negative exploration rates. PATIENTS AND METHODS: We performed a prospective study of all boys treated for 'acute scrotum' at our institute between January 2001 and April 2012 and clinical findings were documented. If available, ultrasonography (US) was added to the diagnostic evaluation. A prediction of the diagnosis was based on clinical and sonographic features, and was followed by surgical exploration in all patients. RESULTS: A total of 104 patients were included in the 16-month period of the study. No single finding excluded TT. The clinical features (pain <24 h, nausea/vomiting, abnormal cremasteric reflex, high position of the testis) appeared predictive (100% sensitivity) and the clinical scoring system was proven to be reliable, reducing the negative exploration rate by >55%. Ultrasound predictors alone were not able to identify all boys with TT. CONCLUSIONS: It is safe to refrain from routine surgical exploration in every child with acute scrotum if the clinical score is applied, which results in a marked reduction of negative explorations. A reliable diagnosis could not be obtained based on US alone. As scrotal US is unpleasant for the child, we propose to refrain from this if the clinical score is positive. Patients with a negative clinical score are suitable candidates for US to establish and secure diagnosis.
OBJECTIVE: To test the clinical and sonographic predictors of testicular torsion (TT) with the aim of reducing negative exploration rates. PATIENTS AND METHODS: We performed a prospective study of all boys treated for 'acute scrotum' at our institute between January 2001 and April 2012 and clinical findings were documented. If available, ultrasonography (US) was added to the diagnostic evaluation. A prediction of the diagnosis was based on clinical and sonographic features, and was followed by surgical exploration in all patients. RESULTS: A total of 104 patients were included in the 16-month period of the study. No single finding excluded TT. The clinical features (pain <24 h, nausea/vomiting, abnormal cremasteric reflex, high position of the testis) appeared predictive (100% sensitivity) and the clinical scoring system was proven to be reliable, reducing the negative exploration rate by >55%. Ultrasound predictors alone were not able to identify all boys with TT. CONCLUSIONS: It is safe to refrain from routine surgical exploration in every child with acute scrotum if the clinical score is applied, which results in a marked reduction of negative explorations. A reliable diagnosis could not be obtained based on US alone. As scrotal US is unpleasant for the child, we propose to refrain from this if the clinical score is positive. Patients with a negative clinical score are suitable candidates for US to establish and secure diagnosis.
Authors: Beat Roth; Ioannis Giannakis; Meret Elisabeth Ricklin; George Niklaus Thalmann; Aristomenis Konstantinos Exadaktylos Journal: Oman Med J Date: 2018-01
Authors: Sol Min Lee; Jung-Sik Huh; Minki Baek; Koo Han Yoo; Gyeong Eun Min; Hyung-Lae Lee; Dong-Gi Lee Journal: J Korean Med Sci Date: 2014-11-21 Impact factor: 2.153
Authors: Mustafa Güneş; Mehmet Umul; Muammer Altok; Mehmet Akyuz; Cemal Selcuk İşoğlu; Fatih Uruc; Bekir Aras; Alpaslan Akbaş; Ercan Baş Journal: Korean J Urol Date: 2015-03-20
Authors: Mustafa Güneş; Mehmet Umul; Muammer Altok; Mehmet Akyüz; Cemal Selçuk İşoğlu; Fatih Uruç; Bekir Aras; Zülfü Sertkaya; Ahmet Ürkmez; Ercan Baş; Muzaffer Oğuz Keleş Journal: Cent European J Urol Date: 2015-06-18
Authors: Ismail Abdul Sattar Burud; Syed Mahmud Irfan Alsagoff; Roshinipriya Ganesin; Sumitta Thamil Selvam; Nor Aniza Binti Zakaria; Mahadevan Deva Tata Journal: Pan Afr Med J Date: 2020-05-29