Pediatric testicular torsion: timely treatment is essential

  • J Pediatr Urol
  • 5 Oct 2018

  • curated by Craig Hicks
  • Clinical Essentials
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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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