Scrotal exploration for suspected testicular torsion: Lessons from 61 consecutive cases presenting at an adult emergency room

Abstract

This study assessed the clinical presentation, diagnosis, and outcomes of patients presenting with acute scrotal pain as an adult emergency who underwent scrotal exploration. A retrospective review was conducted at Korle Bu Teaching Hospital, Ghana, over 5 years. Sixty-one patients aged 10–72 years (median 21) were included. Clinical findings, use of Doppler ultrasound, operative findings, and outcomes were analysed. Testicular torsion was confirmed in 44 patients (72.1%). Clinical evaluation alone achieved a diagnostic accuracy of 74%, while Doppler ultrasound, performed in 55.7% of cases, showed 88.5% sensitivity for torsion. Orchidectomy was required in 39.3% due to gangrenous testes, while 32.8% had viable testes salvaged. Delayed presentation (>72 h) was strongly associated with testicular gangrene (χ² = 31.47, p < 0.00001). Delayed presentation reduces testicular salvage, and in resource-limited settings, careful clinical examination remains central to diagnosing suspected torsion and guiding timely surgical intervention.