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Scrotal exploration for suspected testicular torsion: Lessons from 61 consecutive cases presenting at an adult
James Edward Mensah1, Geoffrey Birinkorang2, Ernest Kwame Adjepong-Tandoh3
1Consultant Urologist, Department of Surgery, Korle Bu Teaching Hospital, Accra, Ghana.
Abstract:
This study assessed the clinical presentation, diagnosis, and outcomes of patients presenting with acute scrotal pain as an adult emergency who underwent scrotal exploration. A retrospective review was conducted at Korle Bu Teaching Hospital, Ghana, over 5 years. Sixty-one patients aged 10-72 years (median 21) were included. Clinical findings, use of Doppler ultrasound, operative findings, and outcomes were analysed. Testicular torsion was confirmed in 44 patients (72.1%). Clinical evaluation alone achieved a diagnostic accuracy of 74%, while Doppler ultrasound, performed in 55.7% of cases, showed 88.5% sensitivity for torsion. Orchidectomy was required in 39.3% due to gangrenous testes, while 32.8% had viable testes salvaged. Delayed presentation (>72 h) was strongly associated with testicular gangrene (χ2 = 31.47, p < 0.00001). Delayed presentation reduces testicular salvage, and in resource-limited settings, careful clinical examination remains central to diagnosing suspected torsion and guiding timely surgical intervention.
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