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

Abstract

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.