Characteristic of testicular torsion and predictors of testicular salvage: A retrospective study

Abstract

Background: Testicular torsion is one of the urological emergencies that require immediate scrotum exploration. Characteristics of testicular torsion patients, variated time exploration, and the findings of the degree of testicular torsion at the time of exploration can affect the outcome of the testicles. The study aimed to determine the characteristics of testicular torsion diagnosed patients and identify the predictors of testicular salvage.Method: The method used in the study was cohort retrospective with inclusion and exclusion criteria. Receiver operator characteristics analysis is performed to determine the probability of orchidectomy based on time to exploration and degrees of twist. Multivariate logistic regression tests are performed to identify the factors that cause the testicles to be retained. P<0.05 was significant.Results: There are 45 patients mostly diagnosed with testicular torsion aged between 12 to 16 years (64.40%). Left testicular torsion was more frequent than the right torsion (82.20%). The etiology of torsion was mostly idiopathic (77.80%). Orchidopexy procedure was performed on 12 testicular torsion patients (26.70%); on follow-up, one patient was found to have testicular atrophy. The time to explore cut-off value 8.5 hours and the 450 degrees of twisting will cause the testis to not survive with the specificity of 83% and 92% and sensitivity of 81% and 82%, respectively. Multivariate analysis shows time to explore and degree of twisting associated with orchidectomy of the affected testis (p<0.05).Conclusion: Patients are relatively young. Not all patients with testicular torsion will manifest typical symptoms of acute, atypical symptoms such as lower abdominal pain, which can be identified as testicular torsion. Mostly affected left testicle. Orchidectomy is the most commonly performed operation on patients. The outcome of testicular torsion can be predicted by observing the time to exploration factor and the degree of testicular torsion in the patient.