Acutely painful scrotum: Tips, traps, tricks and truths

McBride, Craig A.; Patel, Bhaveshkumar

doi:10.1111/jpc.13766

Cited by 3 publications

(4 citation statements)

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“…Testicular torsion refers to ischemia of the testicle due to twisting or rotation of the vessels supplying the testis, through the lengthwise of the spermatic cord presenting as an acute scrotum [ 1 ]. The classic presentation of testicular torsion is a sudden onset of severe unilateral pain, associated with nausea and vomiting; often with referred pain to the ipsilateral iliac fossa [ 2 ]. The examination findings include: a high riding testis with an abnormal transverse lie, a thickened spermatic cord, an absent cremasteric reflex, as well as erythema, tenderness, and swelling [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…The classic presentation of testicular torsion is a sudden onset of severe unilateral pain, associated with nausea and vomiting; often with referred pain to the ipsilateral iliac fossa [ 2 ]. The examination findings include: a high riding testis with an abnormal transverse lie, a thickened spermatic cord, an absent cremasteric reflex, as well as erythema, tenderness, and swelling [ 2 ]. Ultrasonography and Doppler’s study have been regarded to be highly reliable and beneficial in avoiding unnecessary surgical exploration with sensitivity and specificity of 86 to 100% and 95–100% respectively; although their roles have been criticized concerning the accuracy, availability, cost, delay in treatment, and operator-dependence [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Testicular salvageability and its predictors among patients with testicular torsion in a resource limited setting: a multicentre longitudinal study

Mohamed,

Abraha,

Olasinde

et al. 2023

BMC Surg

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Introduction Testicular torsion refers to ischemia of the testicle due to twisting or rotation of the vessels supplying the testes. It is a urologic emergency requiring a high index of clinical suspicion and prompt surgical intervention with management aimed at avoiding testicular loss and resulting infertility. This paper gives an update on the current situation regarding this topic in low-income settings. The aim of this study was to determine testicular salvageability and its predictors amongst patients with testicular torsion at two tertiary African hospitals. Methods This was a hospital-based multicentre longitudinal study at two tertiary hospitals in western Uganda. Patients with acute scrotum were enrolled and evaluated for testicular torsion. Those with confirmed testicular torsion underwent surgery and salvageability was reported as the primary outcome. Predictors for testicular salvageability were determined using backward binary logistic regression in SPSS version 22. Results During the study period, 232 patients with acute scrotum were enrolled. The mean age was 35.3 (SD = 20.4) years. Forty-one (17.7%) patients had testicular torsion. Only 16 (39.0%) of patients with torsion had viable testes that were salvageable. Orchiectomy was performed on 25 patients (61.0%). At multivariate analysis, a patient who presented after 48 h from the onset of symptoms was 34.833 times more likely to have orchiectomy compared to one who presented within 12 h [AOR = 34.833, (95% CI = 5.020-60.711), P < 0.001]. Conclusion In this study, the testicular salvage rate was low. The only predictor of salvageability was the time from the onset of symptoms to presentation. All males should be sensitized about the clinical features of testicular torsion to ensure early presentation to increase salvage rates.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Testicular salvageability and its predictors among patients with testicular torsion in a resource limited setting: a multicentre longitudinal study

Mohamed,

Abraha,

Olasinde

et al. 2023

BMC Surg

View full text Add to dashboard Cite

show abstract

“…Testicular torsion refers to ischemia of the testicle due to twisting or rotation of the vessels supplying the testes through the lengthwise of the spermatic cord presenting as an acute scrotum (1). The classic presentation of testicular torsion is a sudden onset of severe unilateral pain, associated with nausea and vomiting, often with referred pain to the ipsilateral iliac fossa (2). The examination ndings include a high riding testis with an abnormal transverse lie, a thickened spermatic cord, an absent cremasteric re ex, as well as erythema, tenderness, and swelling (2).…”

Section: Introductionmentioning

confidence: 99%

“…The classic presentation of testicular torsion is a sudden onset of severe unilateral pain, associated with nausea and vomiting, often with referred pain to the ipsilateral iliac fossa (2). The examination ndings include a high riding testis with an abnormal transverse lie, a thickened spermatic cord, an absent cremasteric re ex, as well as erythema, tenderness, and swelling (2). Ultrasonography and Doppler's study have been regarded to be highly reliable and bene cial in avoiding unnecessary surgical exploration with sensitivity and speci city of 86 to 100% and 95-100% respectively, although their roles have been criticized concerning the accuracy, availability, cost, delay in treatment, and operator-dependence (3).…”

Section: Introductionmentioning

confidence: 99%

Testicular salvageability and its predictors among patients with testicular torsion in a resource limited setting; a multicentre longitudinal study

Mohamed,

Abraha,

Olasinde

et al. 2023

Preprint

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Introduction Testicular torsion refers to ischemia of the testicle due to twisting or rotation of the vessels supplying the testes. It is a urologic emergency requiring a high index of clinical suspicion and prompt surgical intervention with management aimed at avoiding testicular loss and resulting infertility. There is a paucity of data on this subject in low-income settings. This study was aimed at assessing testicular salvageability and its predictors among patients with testicular torsion at two tertiary African hospitals. Methods This was a hospital-based multicentre longitudinal study at two tertiary hospitals in western Uganda. Patients with acute scrotum were enrolled and assessed for testicular torsion. Those with torsion underwent surgery and salvageability was recorded as the primary outcome. Predictors were determined using backward binary logistic regression in SPSS version 22. Results During the study period, 232 patients with acute scrotum were enrolled. The mean age was 35.3 (SD=20.4) years. Forty-one (17.7%) patients had testicular torsion. Of the 41 diagnosed with torsion, only 16 (39.0%) had viable testis that were salvageable. Orchiectomy was done for 25 (61.0%). At multivariate analysis, a patient who presented after 48 hours from the onset of symptoms was 34.833 times more likely to have orchiectomy compared to one that presented within 12 hours [AOR=34.833, (95% CI=5.020-60.711), P<0.001]. Conclusion In this study, the testicular salvage rate was low. The only predictor of salvageability was the time from the onset of symptoms to presentation. All males should be sensitized about the clinical features of testicular torsion to ensure early presentation in to increase salvage rates.

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Surgical Emergencies in the Pediatric Office

Midura

Statter

2022

Pediatrics in Review

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Infants and children often present with common signs and symptoms that may or may not be manifestations of a surgical emergency. This review expands the differential diagnosis of several common presentations to include surgical causes suggesting surgical emergencies and the need for immediate referral to a pediatric surgeon. The presenting signs and symptoms reviewed include bilious emesis, abdominal distention, acholic stools, bloody stools, and scrotal mass.

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Acutely painful scrotum: Tips, traps, tricks and truths

Cited by 3 publications

References 47 publications

Testicular salvageability and its predictors among patients with testicular torsion in a resource limited setting: a multicentre longitudinal study

Testicular salvageability and its predictors among patients with testicular torsion in a resource limited setting: a multicentre longitudinal study

Testicular salvageability and its predictors among patients with testicular torsion in a resource limited setting; a multicentre longitudinal study

Surgical Emergencies in the Pediatric Office

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