Do repeat ultrasounds affect orchiectomy rate in patients with testicular torsion treated at a pediatric institution?

Huang, Andrew T.; Delozier, Shake; Lauderdale, Chelsea J.; Zhao, Shilin; Clayton, Douglass B.; Pope, John C.; Tanaka, Stacy T.; Adams, Mark C.; Shannon, Chevis N.; Brock, John W.; Thomas, John C.

doi:10.1016/j.jpurol.2018.12.002

Cited by 7 publications

(4 citation statements)

References 13 publications

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“…In this study, 24 (54.5%) children underwent TS and orchiopexy after 6 hours of SP onset, more than the 20% to 40% reported in previous studies 37,39 . All these children with TT underwent TS and orchiopexy in the interval of 6 to 8.5 hours after the onset of SP.…”

Section: Discussionmentioning

confidence: 46%

“…In this study, 24 (54.5%) children underwent TS and orchiopexy after 6 hours of SP onset, more than the 20% to 40% reported in previous studies. 37 , 39 All these children with TT underwent TS and orchiopexy in the interval of 6 to 8.5 hours after the onset of SP. Nonspecific symptoms such as inguinal swelling and pain, scrotal swelling, abdominal pain, and nausea or vomiting might delay the management of TT beyond 6 hours.…”

Section: Discussionmentioning

confidence: 99%

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Factors Determining Testicular Torsion and Consequent Orchiectomy in Pediatric Patients Presenting With Scrotal Pain

Yen,

Chang,

Ming

et al. 2023

Pediatr Emer Care

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Objective Factors associated with testicular torsion (TT) and consequent orchiectomy in patients presenting to pediatric emergency departments (PEDs) with scrotal pain (SP) are not well described. We report the factors predicting TT and consequent orchiectomy in children with SP. Methods The data on patients (aged ≤18 years) who presented with SP to PEDs at 4 branches of the Chang Gung Hospital through 10 years were analyzed. Results In all, 256 pediatric patients presented with SP. Their mean age was 11.60 ± 4.61 years and 72.7% (n = 186) were aged 10 to 18 years. The pain was left-sided in 54.7% (n = 140) and the interval between SP onset and PED arrival was 22.45 ± 31.27 hours. Overall, 84 (32.8%) patients needed surgery and 72 (28.1%) had TT. Of the patients with TT, 28 (38.9%) patients needed an orchiectomy. After analysis, TT and consequent orchiectomy were associated with a longer interval between SP onset and PED arrival, absent of testicular ultrasonic blood flow, interval between SP onset and surgery of more than 24 hours, and a high degree of TT. None of them experienced recurrent SP symptoms or TT again. Conclusions The rate of TT in patients presenting to PEDs with an SP was 28.1%, and 38.9% of the patients with TT needed an orchiectomy. Early diagnosis and intervention helped to prevent subsequent orchiectomy in pediatric patients with TT.

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Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Factors Determining Testicular Torsion and Consequent Orchiectomy in Pediatric Patients Presenting With Scrotal Pain

Yen,

Chang,

Ming

et al. 2023

Pediatr Emer Care

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“…Waldert et al find an orchiectomy rate of 15% in patients without the use of ultrasounds but has no record of follow-up to assess for atrophy [ 10 ]. In general, several studies using ultrasound find a comparable orchiectomy rate [ 8 , 12 , 15 ] while Pinar et al have conducted a retrospective study finding no difference in orchiectomy rates between patients with or without a preceding ultrasound [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

The impact of ultrasound on testicular loss in cases of testicular torsion in children

Buch Kjeldgaard,

Kinder-Klausen,

Nerstrøm

et al. 2024

Pediatr Surg Int

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Purpose Ultrasound as a diagnostic tool in suspicion of testicular torsion is still highly debated. In this investigation, we aimed to evaluate whether time spent on scrotal ultrasonography had a negative impact on testicular loss. Methods Patients’ records containing a scrotal ultrasound and/or surgical procedure codes for testicular interventions on suspicion of testicular torsion were examined. Patients aged 0–15 years admitted during 2015–2019 at Copenhagen University Hospital, Rigshospitalet were included. Results In total, 1566 patients underwent an ultrasound and 142 of these proceeded to surgery while 13 patients proceeded directly to surgery without an ultrasound. The rate of testicular loss with a preceding ultrasound was 23% versus 42% without (p = 0.18). Four cases of testicular torsion were misdiagnosed by ultrasound resulting in a sensitivity of 95.4% and specificity of 95.6%. The mean diagnostic delay from ultrasound examination was 55 ± 39 min, and the mean time from ultrasound to surgery was at 169 ± 76 min versus 171 ± 72 min without ultrasound. Conclusion In a clinical setting, ultrasound provided a reliable tool for the diagnosis of testicular torsion and did not seem to increase the orchiectomy rate.

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“…However, it may occasionally cause erroneous results since it is a operator-dependent technique. Diagnostic failings resulting from the experience of the radiologist in scrotal USG, the fact that torsion may be occasionally intermittent and difficulty in performing USG in little kids are the factors that decline diagnostic strength of color Doppler USG (19). Color Doppler USG was performed in all the patients with TT included in our study.…”

Section: Discussionmentioning

confidence: 99%

Çocuklarda Testis Torsiyonu: 10 Yıllık Retrospektif Bir Çalışma

Gürsoy

Çelikkaya

Seçinti

et al. 2022

Türkiye Çocuk Hast Derg

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Objective:The purpose of the present study is to determine the clinical, radiological and pathological characteristics of testicular torsion patients, the intervention techniques applied according to time to hospital admission of the patient and testis-saving rates in the childhood age group. Material and Methods:This retrospective study included the patients aged between 0-18 years who applied to pediatric surgery clinic due to the complaint of abdominal pain or scrotal pain between January 2011 to January 2021 and were diagnosed with testicular torsion after evaluation. The patient age, hospital admission complaint, duration of the symptoms, month of hospital admission, lateralization of the affected testicle, preoperative diagnostic studies, type of the implemented intervention (orchiectomy/detorsion) and postoperative diagnosis were determined. Hematoxylin-Eosin-stained archive slides of the materials sent to pathology department for examination were reviewed by two pathologists. Results:In this period of 10 years; 28 patients aged between 0-18 years admitted to our hospital because of testicular torsion. Scrotal pain and tenderness were present in all the patients (100%). Of the patients; 4 (14.3%) were neonatal and 21 (75%) were between the ages 12-18 years. Testicular parenchyma could not be macroscopically selected in the examination of orchiectomy materials and the materials were hemorrhagic. Hemorrhagic infarction was detected by microscopic examination. Conclusion:Acute scrotum is a frequently seen surgical emergency in the childhood period. There are many entities that may cause acute scrotum; performing differential diagnosis accurately and timely can protect the patient from unnecessary surgery and testicular loss.

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Do repeat ultrasounds affect orchiectomy rate in patients with testicular torsion treated at a pediatric institution?

Cited by 7 publications

References 13 publications

Factors Determining Testicular Torsion and Consequent Orchiectomy in Pediatric Patients Presenting With Scrotal Pain

Factors Determining Testicular Torsion and Consequent Orchiectomy in Pediatric Patients Presenting With Scrotal Pain

The impact of ultrasound on testicular loss in cases of testicular torsion in children

Çocuklarda Testis Torsiyonu: 10 Yıllık Retrospektif Bir Çalışma

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