Testicular torsion: Losses from missed diagnosis and delayed referral despite early presentation

Ogbetere, Friday Emeakpor

doi:10.4103/njcp.njcp_432_20

Cited by 1 publication

(1 citation statement)

References 4 publications

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“…A study conducted in Brazil concluded that the highest testicular salvage rate was in tertiary hospitals, which is consistent with the results of the present study 6 . Kumar et al 15 and Ogbetere et al 16 demonstrated that a greater effort to educate primary health care professionals may reduce this delay. Small/medium community hospitals exhibited the lowest orchiectomy rates in Canada, and longer ER throughput was consistently associated with loss of the testicle 17 , which could be related to the higher level of medical care in developed countries.…”

Section: Discussionmentioning

confidence: 99%

Analysis of factors associated with delayed diagnosis and treatment of testicular torsion in 1005 cases from Chongqing city, China: a cross-sectional study

Yi,

Wang,

et al. 2023

Sci Rep

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This study aimed to investigate the clinical and social factors of delayed treatment for testicular torsion (TT) and to explore the risk factors of testicular excision in China. The clinical data of 1005 patients with TT who were admitted to 48 medical institutions in Chongqing city (China) from January 2012 to December 2021 were retrospectively analyzed. It was revealed that the misdiagnosis rates of non-senior (junior and middle) grade doctors and senior doctors were 25.1% and 9.6%, respectively. The proportion of TT patients who received timely treatment (within 6 h after onset of symptoms) was 23.8%. The results of the multivariable logistic regression analysis indicated that absent cremasteric reflex was a protective factor for delayed surgery of more than 6 h from onset of symptoms to surgery. Misdiagnosis, consultation with a non-urologist as the first consultant doctor, absence blood flow in color Doppler ultrasound, negative high-riding testis findings, the presence of fever, and non-manual detorsion were identified as risk factors associated with delayed surgery (more than 6 h from the onset of symptoms) for TT. Furthermore, misdiagnosis, non-urologist first-consultant doctor, absent blood flow in DUS, non-manual detorsion, fever, degree of cord twisting > 180, and the initial diagnosis in tertiary hospitals were risk factors for orchidectomy. Having TT on the right side, and the presence of nausea and vomiting were identified as protective factors for orchidectomy. Technical training in the diagnosis and treatment of TT should be extended to primary hospitals and doctors to significantly improve their accuracy in managing this condition.

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