Spermatic cord torsion: a retrospective analysis

Area of Science:

• Urology
• Surgical Sciences
• Public Health

Background:

• Testicular torsion is a surgical emergency requiring prompt diagnosis and treatment to prevent testicular loss.
• Delays in presentation and interhospital transfer can significantly impact treatment outcomes.

Purpose of the Study:

• To evaluate the time intervals and identify delays in the management pathway for testicular torsion.
• To assess the correlation between delayed treatment and orchiectomy rates.

Main Methods:

• Retrospective analysis of surgically treated testicular torsion cases from 2018-2021.
• Evaluation of time intervals: pain onset to first presentation (D1), interhospital transfer (D2), pain onset to urological evaluation (D3), evaluation to surgery (D4), and pain onset to surgery (D5).
• Analysis of demographic data, surgical outcomes, and orchiectomy rates across different time intervals.

Main Results:

• A total of 87 cases with complete data were analyzed.
• Median time from pain onset to surgical treatment (D5) was 24 hours 42 minutes.
• Orchiectomy rates were significantly higher in patients with delayed presentation (D1 > 24 hours: 91.18%) compared to early presentation (D1 ≤ 6 hours: 24.24%).

Conclusions:

• Late emergency department arrival and prolonged interhospital transfer times are major contributors to orchiectomy in testicular torsion cases.
• Developing public health measures and preventive strategies is essential to minimize delays and reduce the rate of testicular loss.
• Optimizing the patient pathway from symptom onset to surgical intervention is critical for testicular preservation.