Acute Abdominal Pain: the Importance of Genital Examination

Guta, Daniel; Leduc, F.; Herman, D.

doi:10.1080/00015458.2011.11680781

Cited by 12 publications

(9 citation statements)

References 4 publications

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“…Several studies have shown that torsion is more common with a UDT compared with a completely descended testis. There are articles proposing 10 times higher risk of torsion in cryptorchid testis [3] , [4] , [5] , [6] . Johnson [11] reported an incidence of 21% of torsion in cryptorchid testes.…”

Section: Discussionmentioning

confidence: 99%

“…The literature concerning UDT mainly concentrates on the increased risks of infertility and germ cell tumor development as the primary sequelae of this condition. The UDT is also at higher risk for torsion [2] , [3] , [4] , [5] ; misdiagnosis or delayed diagnosis of testicular torsion with subsequent testicular loss is a relatively common subject of litigation. Only a few cases of torsion in UDT have been reported in the current literature and are mostly limited to case reports [6] .…”

Section: Introductionmentioning

confidence: 99%

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Testicular torsion in undescended testis: A persistent challenge

Naouar¹,

Salem²,

Kamel³

2017

Asian Journal of Urology

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ObjectiveTo evaluate the management and outcomes of patients who presented with torsion of an undescended testis and review the reported series in the literature.MethodsThe case records of 13 patients operated for testicular torsion involving undescended testis were retrospectively reviewed. The medical records included age at presentation, medical history, physical examination, operative findings and the results of follow-up. The diagnosis of torsion of undescended testis was made clinically and confirmed by inguinal exploration.ResultsIn six cases the testis was preserved and orchiopexy was performed, while in seven cases orchidectomy was performed due to testicular gangrene in six patients and testicular tumor discovered peroperatively in one case. Mean duration of symptoms at time of surgery in the orchiopexy group was 6.5 h and in the orchidectomy group was 21.2 h. From six patients treated by orchiopexy, two patients suffered from testicular atrophy at a mean of 24 months.ConclusionTesticular torsion in undescended testis is still diagnosed with delay which may affect testicular salvage. The importance of examination of external genital organs is highlighted which should be routinely included by emergency physicians in physical examination for abdominal or groin pain.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Testicular torsion in undescended testis: A persistent challenge

Naouar¹,

Salem²,

Kamel³

2017

Asian Journal of Urology

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“…In several studies, children with acute testicular torsion have symptoms other than scrotal pain and swelling, such as abdominal pain, nausea, and vomiting. 7 – 9 It is crucial for providers to perform a focused genital examination for boys who present with abdominal pain, especially when patients may not be able to accurately describe their symptomatology.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Rate of Testicular Salvage in Acute Testicular Torsion at a Tertiary Pediatric Center

Ramachandra¹,

Palazzi²,

Holmes³

et al. 2015

WestJEM

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IntroductionStudies have demonstrated that variables other than duration of symptoms can affect outcomes in children with acute testicular torsion. We examined demographic and logistical factors, including inter-hospital transfer, which may affect outcomes at a tertiary pediatric referral center.MethodsWe reviewed charts of all pediatric patients with acute testicular torsion during a five-year period. Data were collected regarding age, insurance type, socioeconomic status, duration of symptoms prior to presentation, transfer status, time of day, time to surgical exploration, and testicular salvage.ResultsOur study included 114 patients. Testicular salvage was possible in 55.3% of patients. Thirty-one percent of patients included in the study were transferred from another facility. Inter-hospital transfer did not affect testicular salvage rate. Time to surgery and duration of pain were higher among patients who underwent orchiectomy versus orchidopexy. Patients older than eight years of age were more likely to undergo orchidopexy than those younger than eight (61.5% vs. 30.4%, p=0.01). Ethnicity, insurance type, or time of day did not affect the testicular salvage rates. On multivariate analysis, only duration of symptoms less than six hours predicted testicular salvage (OR 22.5, p<0.001).ConclusionEven though inter-hospital transfer delays definitive surgical management, it may not affect testicular salvage rates. Time to presentation is the most important factor in predicting outcomes in children with acute testicular torsion.

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“…The consequences of an undescended testicle are higher risk of testicular cancer (5) and impaired fertility (6). Moreover, cryptorchidism is connected with a higher risk of gonadal torsion (7)(8)(9). Because of the risk of testicular necrosis, torsion of the gonad is the most urgent disorder and surgical emergency.…”

Section: Introductionmentioning

confidence: 99%

Is Testicular Torsion a Real Problem in Pediatric Patients With Cryptorchidism?

et al. 2021

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Purpose: To present management and outcomes of patients with cryptorchidism suffering from testicular torsion.Methods: This is a retrospective review of pediatric patients with torsion of undescended testes, who were treated between 2009 and 2019. We recorded: the age, symptoms, duration of torsion, results of physical examination, surgery findings, and additional treatment. Additionally, an extensive online literature search, from 2015–2020, was performed to identify other similar case series.Results: We identified 9 boys with torsion of the undescended gonad, which represented 4.7% of all 192 boys with testicular torsion. The mean age of boys with torsion of undescended testis was 8.7 years. The mean duration of symptoms in our study group was long and it was up to 28.5 h. All patients had inguinal canal exploration. In eight cases, testicular necrosis and primary orchidectomy was performed. Furthermore, 45 cases were identified in the literature and reviewed.Conclusion: According to clinical experience and available studies, torsion of male undescended gonads is a comparatively rare condition. Nevertheless, diagnosis is still delayed and connected with inevitable orchidectomy.

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Acute Abdominal Pain: the Importance of Genital Examination

Cited by 12 publications

References 4 publications

Testicular torsion in undescended testis: A persistent challenge

Testicular torsion in undescended testis: A persistent challenge

Factors Influencing Rate of Testicular Salvage in Acute Testicular Torsion at a Tertiary Pediatric Center

Is Testicular Torsion a Real Problem in Pediatric Patients With Cryptorchidism?

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