Testicular Loss in Children Due to Incorrect Early Diagnosis of Torsion

Abstract

Background. Testicular torsion is a common surgical emergency in children that requires a high index of suspicion, early diagnosis, and exploration. Most children present early to their primary pediatricians or physicians. The aim of this retrospective study is to determine the surgical outcome of testicular torsion with early as well as delayed presentation or referral at our pediatric surgical unit. Methods. Records of 50 patients who presented with testicular torsion at our pediatric surgical unit over the span of 10 years (2007-2017) were reviewed retrospectively. The duration and characteristics of symptoms, initial consultation with primary care health professional, time duration between the initial consultation and referral to a tertiary care center, clinical findings prior to surgery, and operative findings were noted. Results. Fifty patients were in the age group ranging from 38 days to 18 years. All the patients consulted the primary care health professionals within 3 to 6 hours after the onset of testicular pain. The patients presented to our hospital within the range of 3.5 hours to 10 days of onset of initial symptoms. Out of 50 patients who presented to our hospital with torsion testis, 45 (90%) patients underwent orchidectomy as the testicle was gangrenous and 5 patients underwent orchiopexy as the testicle was viable. Conclusion. The risk of testicular loss is very high if there is delay in the initial diagnosis of testicular torsion. Greater effort in educating the primary health care professionals may reduce this delay. Primary objective of treating the acute scrotum should be prevention of testicular loss than treating symptoms.