The management of testicular torsion in the UK: How can we do better? A national quantitative and qualitative analysis of the factors affecting successful testicular salvage

Ryan, Kate; Folkard, S; Bastianpillai, Christopher; Green, James S. A.

doi:10.1016/j.jpurol.2020.08.018

Cited by 15 publications

(19 citation statements)

References 18 publications

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“…Clinically, there are three recognized components required to salvage a torted testicle [1,13]. Firstly, the patient needs to present promptly for medical attention, secondly, the correct diagnosis needs to be made, and thirdly, time-critical surgery is required.…”

Section: Discussionmentioning

confidence: 99%

“…NHS England is the largest subsidiary, with 1.5 million employees, and is responsible for commissioning all healthcare in England through primary, secondary and tertiary care providers [11,12]. There are 237 secondary care trusts in England who provide the majority of acute services, of which 134 provide paediatric care [13]. Overlying this care is a nationwide Quality Assurance and Quality Improvement Network led by NHS England to provide safe, high-quality, compassionate care.…”

Section: Introductionmentioning

confidence: 99%

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Serious incidents in testicular torsion management in England, 2007–2019: optimizing individual and training factors are the key to improved outcomes

et al. 2021

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To establish the healthcare factors that contribute to testicular torsion adverse events (orchidectomies) and 'near misses'. The secondary objective was to identify areas suitable for impactful quality improvement initiatives to be undertaken by National Health Service (NHS) healthcare providers nationally. Materials and MethodsThis was a retrospective record review and analysis, carried out in four phases. We applied the well-validated London Protocol patient safety incident analysis framework to all eligible serious incidents related to testicular torsion submitted by English NHS Trusts over a 12-year period to the Strategic Executive Information System database. Clinical reviewers established the incident population (Phase 1), were trained and piloted the feasibility of using the London Protocol (Phase 2), applied the protocol and themed the identified contributing factors linked to adverse events (orchidectomies) and nearmisses (Phase 3), and reviewed the evidence for improvement interventions (Phase 4).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Serious incidents in testicular torsion management in England, 2007–2019: optimizing individual and training factors are the key to improved outcomes

et al. 2021

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Section: Introductionmentioning

confidence: 99%

“…Several factors are associated with delayed or inaccurate diagnosis of testicular torsion which increase the likelihood that the affected testicle will not be salvaged, including isolated abdominal pain, failure to perform a thorough genitourinary exam, scrotal imaging, late presentation to the Emergency Department (ED), and pediatrician evaluation prior to the ED. [9][10][11][12] A child is diagnosed with a developmental delay when he/she does not attain developmental milestones compared to peers of the same age range. 13 Approximately 10% to 15% of children <5 years old will experience developmental delays that manifest in varying degrees of severity.…”

Section: Introductionmentioning

confidence: 99%

Testicular Torsion in Patients With Intellectual and Developmental Disabilities

Shields

Daniels

Peppas

et al. 2021

Global Pediatric Health

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Patients with intellectual/developmental disabilities are at risk of delayed diagnosis of testicular torsion due to their inability to effectively communicate their symptoms. We identified males ages 1 to 18 years with testicular torsion between January 1, 2015 and December 31, 2020, focusing on patients with intellectual and/or developmental disabilities. Of the 140 patients with testicular torsion, 5 (3.6%) patients exhibited intellectual/developmental disabilities with an inability to effectively verbalize testicular/groin/scrotal pain. The patients with intellectual/developmental disabilities underwent more orchiectomies (5/5, 100%, P = .009) and had a longer duration of symptoms (median = 48 hours, P = .047) compared to those without intellectual/developmental disabilities (51/135, 38% and median = 9 hours, respectively) (51/134, 38%) ( P = .038). Parents and other caregivers of males with intellectual/developmental disabilities who are unable to adequately verbalize their testicular/groin/scrotal pain should be cognizant of the signs and symptoms associated with testicular torsion, perform a genitalia examination, and seek an immediate evaluation to diagnose and treat this urgent condition.

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“…It is among the outstanding indications that require urgent surgical intervention in children. Although prevalent in all age groups, testicular torsion has a significant peak in adolescents and young men [2,3].…”

Section: Introductionmentioning

confidence: 99%

The impact of bone marrow-derived mesenchymal stem cells on experimental testicular torsion in rats

Ertürk¹,

Demir²,

Günal³

et al. 2021

Turk J Med Sci

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The management of testicular torsion in the UK: How can we do better? A national quantitative and qualitative analysis of the factors affecting successful testicular salvage

Cited by 15 publications

References 18 publications

Serious incidents in testicular torsion management in England, 2007–2019: optimizing individual and training factors are the key to improved outcomes

Serious incidents in testicular torsion management in England, 2007–2019: optimizing individual and training factors are the key to improved outcomes

Testicular Torsion in Patients With Intellectual and Developmental Disabilities

The impact of bone marrow-derived mesenchymal stem cells on experimental testicular torsion in rats

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