Pediatric Testicular Torsion: Demographics of National Orchiopexy Versus Orchiectomy Rates

Abstract

Nationally an average of 32% of the 411 pediatric torsion cases explored annually result in orchiectomy. Identified factors increasing the orchiectomy risk included age 1 to 9 years, black race and lack of private insurance. Efforts should continue to identify modifiable variables that can increase testicular salvage in patients with testicular torsion.

Testicular torsion and weather conditions: analysis of 21,289 cases in Brazil

“…Shukla et al were the first authors to hypothesize an association between cold weather and testicular torsion in 1982 (3). Since than, a total of 9 studies have found a positive association between low ambient temperature and testicular torsion (3-11) whereas 4 did not (12)(13)(14)(15). All studies that found a positive association were conduced in cold regions or regions with high temperature amplitude.…”

“…On the other hand, there are four studies that have not observed seasonal variation of testicular torsion. In a series of 2,876 men, Cost et al have not observed seasonal variations of testicular torsion (15). However, this study included men from all across the United States, a country with very different weather conditions, without distinctions according to regions' temperature (15).…”

“…patients evaluated (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Different conclusions were drawn from these studies regarding the validity of the hyperactive cremasteric reflex theory.…”

Testicular torsion: A retrospective investigation of predictors of surgical outcomes and of remaining controversies

“…Although much is known about TT, recent reviews have identified remaining controversies [3,4]. For instance, some research has indicated that Caucasian patients have a greater chance of having the testicle salvaged than minorities [5], but other studies have reported no difference between groups [6]. Patients who underwent orchiectomies have been shown to be older in some [5,6] but not all [2] studies.…”

Cold weather is a predisposing factor for testicular torsion in a tropical country. A retrospective study

“…[15][16][17] However, Cost et al 17 Brazil reported an increase in the occurrence of torsion during the winter, 18 but it included patients with testicular torsion presumed on admission, thus making it difficult to establish precise conclusions, because only 16% to 42% of boys with acute scrotal pain have surgically confirmed testicular torsion. [19][20][21] Hypothesizing that cold weather is the main initiating event for acute testicular torsion would be too simplistic.…”