Testicular torsion: A retrospective investigation of predictors of surgical outcomes and of remaining controversies

Castañeda-Sánchez, Irene; Tully, Briana; Shipman, Mary; Hoeft, Alice; Hamby, Tyler; Palmer, Blake

doi:10.1016/j.jpurol.2017.03.030

Cited by 30 publications

(30 citation statements)

References 17 publications

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“…TT is a relatively rare urological emergency, most commonly encountered in vulnerable children and adolescents. Torsion of the left testicle is more common than the right one, [6][7][8][9] consistent with findings in the present study. Some abnormalities that occur during development of the male reproductive system have reportedly been associated with TT morbidity.…”

Section: Discussionsupporting

confidence: 92%

Effect of unilateral testicular torsion at different ages on male fertility

Zhang

Cai

et al. 2020

J Int Med Res

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Objective To investigate the effect of early-life unilateral testicular torsion on adult male fertility. Methods Clinical information was collected for 122 patients who had experienced unilateral testicular torsion at a median age of 15.5 years. The recent pregnancy rate and time to pregnancy experienced by the patients’ female partners were assessed by structured interviews. Data were analyzed by the chi-squared test and Student’s t-test. Results Seventy-two patients with testicular torsion met the criteria for inclusion in our analyses; 49 had undergone orchiectomy, while 23 had undergone surgical repositioning/orchiopexy. The pregnancy rate and median time to pregnancy were 83.67% (41/49) and 1.6 years, respectively, in the orchiectomy group, whereas they were 91.30% (21/23) and 0.75 years, respectively, in the repositioning/orchiopexy group. The recent pregnancy rate was higher in patients with torsion in childhood than in patients with torsion in adolescence; it was lowest in patients with torsion in adulthood. Surgical repositioning/orchiopexy yielded a significantly better recent pregnancy rate among the three groups, based on age at the time of torsion, and a shorter time to pregnancy than orchiectomy in patients with torsion in adolescence. Conclusion Onset of unilateral testicular torsion early in life has a negligible effect on adult male fertility.

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Section: Discussionsupporting

confidence: 92%

Effect of unilateral testicular torsion at different ages on male fertility

Zhang

Cai

et al. 2020

J Int Med Res

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“…If the testis seems salvageable an orchiopexy is performed, where the testis is detorsed and fixated in the scrotum. Salvageability of the torsed testis has been found to correlate with the duration of torsion and thereby overall time of ischemia [5,6]. This was demonstrated in a study by Yang and colleagues [3] who found that patients undergoing orchiopexy experienced a mean of 360 degrees torsion and 12 hours of pain symptoms and that the orchiectomy patients experienced a mean of 540 degrees torsion and 90 hours of pain symptoms.…”

Section: Testicular Function After Testicular Torsionmentioning

confidence: 97%

The Impact of Testicular Torsion on Testicular Function

Jacobsen

Rudlang

Fode

et al. 2020

World J Mens Health

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Torsion of the spermatic cord is a urological emergency that must be treated with acute surgery. Possible long-term effects of torsion on testicular function are controversial. This review aims to address the impact of testicular torsion (TT) on the endocrine-and exocrine-function of the testis, including possible negative effects of torsion on the function of the contralateral testis. Testis tissue survival after TT is dependent on the degree and duration of TT. TT has been demonstrated to cause longterm decrease in sperm motility and reduce overall sperm counts. Reduced semen quality might be caused by ischemic damage and reperfusion injury. In contrast, most studies find endocrine parameters to be unaffected after torsion, although few report minor alterations in levels of gonadotropins and testosterone. Contralateral damage after unilateral TT has been suggested by histological abnormalities in the contralateral testis after orchiectomy of the torsed testis. The evidence is, however, limited as most human studies are small case-series. Theories as to what causes contralateral damage mainly derive from animal studies making it difficult to interpret the results in a human context. Large long-term follow-up studies are needed to clearly uncover changes in testicular function after TT and to determine the clinical impact of such changes.

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“…Castañeda-S anchez et al [31] reported that inhospital times were 5.57 h in the orchiectomy group and 3.6 h in the salvaged group. We also found that in-hospital times (T2) were longer in the orchiectomy group (4.1 h) than in the salvaged group (2.6 h) as described in literature [9,28].…”

Section: Influence Of Prehospital and In-hospital Times On Testicularmentioning

confidence: 97%

Impact of treatment delays on outcome of acute testicular torsion: a 15-year retrospective study

Steeman

Ngatchou

Ramadan

et al. 2021

Acta Chirurgica Belgica

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Introduction: Preservation of the testicle is directly associated with the duration of torsion. The aim in this retrospective study was to identify factors that influence pre-and in-hospital times and measure the extent to which these times affect testicle survival. Patients and methods: A retrospective review of 116 patients who underwent exploration for testicular torsion between 2000 and 2015. Patients were divided into orchiectomy and salvaged testicle groups. Times in patient management and clinical features were compared with Mann-Whitney, chi-squared, and Fisher exact tests. Multivariate logistical regression was used to identify independent factors associated with orchiectomy. Results: The median prehospital time of 48 h (15.4-138 h) in the orchiectomy group was longer than the 2.4 h (1.6 h-5.2h) in the salvaged group. Patients examined by a general practitioner (GP) prior to presenting at hospital had a median prehospital time of 48 h, compared to 3 h for patients not examined before presentation at hospital. In-hospital times between admission and operation room, as well as times between ultrasonography and operation room, were also longer in the orchiectomy group. Previous GP consultation (OR ¼ 27.26, 95% CI 2.32-320.59, p ¼ .009), prehospital time (OR ¼ 1.04, 95% CI 1.01-1.07, p ¼ .003) and nausea (OR ¼ 9.25, 95% IC 1.33-64.52, p ¼ .025) were independent predictive factors associated with orchiectomy. Conclusion: Prehospital time was a determining factor in orchiectomy. For each extra hour of prehospital delay, the risk of orchiectomy increased by 4%. The rate of orchiectomy was higher among patients who first consulted a GP.

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Testicular torsion: A retrospective investigation of predictors of surgical outcomes and of remaining controversies

Cited by 30 publications

References 17 publications

Effect of unilateral testicular torsion at different ages on male fertility

Effect of unilateral testicular torsion at different ages on male fertility

The Impact of Testicular Torsion on Testicular Function

Impact of treatment delays on outcome of acute testicular torsion: a 15-year retrospective study

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