Aderivaldo Cabral Dias Filho1, Ruytemberg Oliveira Rodrigues2, Cassio L Z Riccetto3, Paulo Gonçalves Oliveira4. 1. Urological Unit, Hospital de Base do Distrito Federal, Brasilia, Brazil. Electronic address: aderivaldo.uro@gmail.com. 2. Urological Unit, Hospital de Base do Distrito Federal, Brasilia, Brazil. 3. Department of Surgery, Division of Urology, Hospital das Clínicas da Universidade Estadual de Campinas, Campinas, Brazil. 4. Department of Surgery, Faculdade de Ciências Médicas da Universidade de Brasília, Brasilia, Brazil.
Abstract
PURPOSE: We compared surgical outcomes between patients undergoing and those not undergoing preoperative manual detorsion for intravaginal testicular torsion. MATERIALS AND METHODS: We retrospectively analyzed consecutive patients treated surgically for testicular torsion who were examined within 24 hours of symptoms at our emergency department between January 2012 and September 2015. Explanatory variables were age, presentation delay (time between symptoms and urological examination), surgical wait time (time from examination to surgery), and whether manual detorsion was attempted and, if attempted, was declared successful. End points were surgical outcome (orchiopexy, orchiectomy) and testicular rotation at surgery. Statistical analysis included nonparametric tests and logistic regression. Statistical significance and confidence intervals were set at p <0.05 and 0.95, respectively. RESULTS: Detorsion was attempted in 76 of 133 cases (57.1%) and was successful in 72 (95.1%). Patient age (median 15.6 vs 17.4 years, p = 0.115), presentation delay (6.6 vs 6.3 hours, p = 1.0) and surgical wait time (3.5 vs 3.2 hours, p = 0.412) were comparable between patients who underwent manual detorsion attempt and those who did not. Testicular rotation was less among successfully detorsed patients. Orchiectomy was performed in 2 of 72 successfully detorsed patients (2.8%), compared to 15 of 61 patients (24.6%) in whom detorsion was not attempted or was unsuccessful (OR 11.23, p = 0.0002). Logistic regression indicated that surgical wait time (OR 0.95, p = 0.002) and successful detorsion (OR 17.38, p = 0.001) were independently associated with orchiopexy. CONCLUSIONS: Preoperative manual detorsion was associated with improved surgical salvage in patients with testicular torsion.
PURPOSE: We compared surgical outcomes between patients undergoing and those not undergoing preoperative manual detorsion for intravaginal testicular torsion. MATERIALS AND METHODS: We retrospectively analyzed consecutive patients treated surgically for testicular torsion who were examined within 24 hours of symptoms at our emergency department between January 2012 and September 2015. Explanatory variables were age, presentation delay (time between symptoms and urological examination), surgical wait time (time from examination to surgery), and whether manual detorsion was attempted and, if attempted, was declared successful. End points were surgical outcome (orchiopexy, orchiectomy) and testicular rotation at surgery. Statistical analysis included nonparametric tests and logistic regression. Statistical significance and confidence intervals were set at p <0.05 and 0.95, respectively. RESULTS: Detorsion was attempted in 76 of 133 cases (57.1%) and was successful in 72 (95.1%). Patient age (median 15.6 vs 17.4 years, p = 0.115), presentation delay (6.6 vs 6.3 hours, p = 1.0) and surgical wait time (3.5 vs 3.2 hours, p = 0.412) were comparable between patients who underwent manual detorsion attempt and those who did not. Testicular rotation was less among successfully detorsed patients. Orchiectomy was performed in 2 of 72 successfully detorsed patients (2.8%), compared to 15 of 61 patients (24.6%) in whom detorsion was not attempted or was unsuccessful (OR 11.23, p = 0.0002). Logistic regression indicated that surgical wait time (OR 0.95, p = 0.002) and successful detorsion (OR 17.38, p = 0.001) were independently associated with orchiopexy. CONCLUSIONS: Preoperative manual detorsion was associated with improved surgical salvage in patients with testicular torsion.
Authors: D I Chu; K Gupta; T Kawal; J P Van Batavia; D K Bowen; M R Zaontz; T F Kolon; D A Weiss; S A Zderic; D A Canning Journal: J Pediatr Urol Date: 2018-02-06 Impact factor: 1.830
Authors: Mohammed Elifranji; Tariq Abbas; Bruno Leslie; Santiago Vallasciani; Abderrahman El Kadhi; João Luiz Pippi-Salle Journal: Int Braz J Urol Date: 2022 Jul-Aug Impact factor: 3.050