Clinical risk factors for non salvageable testis in pediatric and adult testicular torsion patients

Indradiputra, I Made Udiyana; Daryanto, Besut; Seputra, Kurnia Penta; Satyagraha, Paksi; Nurhadi, Pradana

doi:10.1016/s1569-9056(17)30742-x

Cited by 1 publication

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“…et al, about 80% of Testicular torsion level in patients with acute scrotal in Saiful Anwar General Hospital was found 63%, with a very low rescue rate (18%). In comparison, Magoha et al found a rate of 86.36% with a rescue rate of 21%(11).It must be noted that the time to come to our facilities and the average complaint time (19 hours) found in this study is relatively high, and this may also contribute to the poor level of testicular salvage.…”

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confidence: 57%

“…Incorrect use of history taking and physical examination to diagnose torsion testis can prolong the delay and cost, and depend on imaging requirements (11)(12)(13). According to Moosaje et al, of the 60 patients studied, 43 patients with torsion testis were found at a cut point value of 5 with a sensitivity value of 97.7% and a PPV of 95.6% (5).…”

Section: Discussionmentioning

confidence: 99%

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Validation of TWIST (Testicular Workup for Ischemia and Suspected Torsion) Score System for Differential Diagnosis in Acute Scrotum in Tertiary Teaching Hospital

Prayudi

Daryanto

Budaya

2022

JKB

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The acute scrotum is a common urological emergency and has a broad differential diagnosis. There is no clear consensus on a particular algorithm to follow in the diagnosis of testicular torsion. Testicular Workup for Ischemia and Suspected Torsion (TWIST) Score, a risk scoring system based on signs and symptoms, can be invaluable in managing patients with the acute scrotum, specifically testicular torsion. This study aimed to evaluate the effectiveness of the TWIST scoring system for differential diagnosis of acute scrotal patients. The study was conducted using secondary data, medical records from 111 male patients diagnosed with acute scrotum in Saiful Anwar General Hospital Malang between January 2015 and December 2018. Data about the onset of pain, first contact, history, physical examination findings, any adjunct test performed, and intra-operative findings were collected. The effectiveness of the TWIST score in diagnosing testicular torsion was determined by calculating the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Of the 111 patients, 43 patients (38.7%) had testicular torsion. The mean age was 17.49 (6.69) years. A total of 39 patients were classified as high risk as per the TWIST Score with cut point 5 had 83.7% sensitivity, 95.6% specificity, 92.3% positive predictive value (PPV), and 90.3% negative predictive value (NPV). The area under the curve was 0.93. The use of the TWIST Score in clinical practice can accurately determine high-risk patients who can proceed straight to the operating theatre without the need for an ultrasound.

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confidence: 57%

Section: Discussionmentioning

confidence: 99%