Takeaway
- Pediatric patients with testicular torsion must receive treatment early to increase the likelihood of salvage.
Why this matters
- "[I]t would be reasonable to [counsel] families that after 6 hours there is concern for testicular survival and after 10 hours significant possibility of testicular loss," say researchers.
Key results
- Orchidectomy rates at surgery for testicular torsion ranged from 20% to 60% (mean, 39%).
- Longer-term rates of testicular loss ranged 30%-67% (mean, 49%).
- Predictors of testicular loss included time until treatment; non-emergency department presentation; transfer to a tertiary center; degree of torsion; Hispanic, black, or Asian ethnicity; low social affluence; and use of ultrasound prior to diagnosis or transfer.
Study design
- Researchers reviewed 12 studies to investigate early and long-term (>12 months) pediatric testicular loss rates following torsion, using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
- Funding: None disclosed.
Limitations
- The quality of studies included in the analysis was generally low.
- Follow-up bias affected all but 1 study; 6 had no long-term follow up; and 5 had no case-control.
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