Public awareness of testicular torsion is lacking in Edmonton

The time from symptom onset to intervention dictates morbidity in testicular torsion (TT). Delayed presentation negatively impacts surgical outcomes and poor knowledge about TT is hypothesized to be a potential cause of delay. Our study characterizes baseline public awareness rates among families in Edmonton and assesses the association between awareness and TT outcomes.

Patients and their caregivers completed surveys assessing TT awareness. Families were surveyed in two groups: those who presented with TT and age-matched controls. Affected families gave additional information about symptoms, time to notify parents, and present to the hospital. Outcomes were assessed at followup and through medical record review.

Of 61 families, 18 (29.5%) patients and 22 (36.1%) parents had heard of TT. Among TT-affected patients (n=30), time to report symptoms (3.2 vs. 20.5 hours, p<0.01) and to arrive at hospital (3.0 vs. 20.8 hours, p<0.01) was significantly longer for patients requiring orchiectomy. Total time (odds ratio [OR] 0.992, p=0.01) and pain (OR 0.904, p=0.05) were associated with outcome. No differences in awareness were seen between patients who underwent orchiopexy vs. orchiectomy (23.8% vs. 25.0%, p>0.99).

We demonstrate that most Edmonton families have never heard of TT and that the pre-admission interval constitutes a substantial proportion of delays in surgery. Although time and pain ratings were associated with outcomes in TT, further evidence is required to demonstrate that awareness impacts outcomes significantly.