Predictive factors for orchiectomy in adult's spermatic cord torsion: a case-control study

Spermatic cord torsion (SCT) is a surgical emergency. Any delay in diagnosis or treatment may compromise the vital and functional prognosis of the testicle. The orchiectomy rate remains very high in the literature; it can even reach 50 % in certain series. Several factors have been reported in the literature as being significantly correlated with the risk of orchiectomy: duration of symptoms, the number of turns, the younger ages, etc. The objective of this study has been to analyse the predictive factors of orchiectomy in adult SCT in our context.

During the study period, 74 cases of SCT were included. Orchidopexy was performed in 43.2 % (32/74) versus orchiectomy in 56.8 % (42/74) of cases. The patients' median age was 22 years (interquartile range (IQR) = 18-26.75 years). The duration of symptoms (p = 0.009), the previous medical management (p < 0.001), performing a scrotal ultrasonography (p = 0.004) were statistically significant at univariate analysis. On multivariate analysis only the previous medical management was statistically significant (p = 0.017).

The orchiectomy rate was very high in our cohort. The previous medical management was the only significant predictive factor of orchiectomy on multivariate analysis. Our findings demonstrated that the delay in diagnosis is the determining factor in testicular loss in our context.