Differences in Clinical Characteristics Between Prepubescent and Postpubescent Males With Testicular Torsion

Abstract

Testicular torsion represents a pediatric surgical emergency. In this 6-year study with 140 patients, prepubescent (<13 years) and postpubescent (≥13 years) males with testicular torsion were identified. Prepubescent boys had a longer symptom duration ( P = .016) and underwent more orchiectomies ( P = .005) compared with postpubescent boys. The risk of orchiectomy decreased by 15% per 1-year increase in age ( P = .002). Boys who underwent an orchiectomy had a longer symptom duration ( P < .001), were younger ( P = .002), had scrotal swelling ( P = .001), scrotal erythema ( P < .001), higher degrees of torsion ( P = .036), and more left-sided surgeries ( P = .014) compared with those who had an orchiopexy. Postpubescent boys were 63% less likely to receive an orchiectomy versus an orchiopexy compared with prepubescent boys. Pediatricians should be cognizant of the age discrepancies between prepubescent and postpubescent males with testicular torsion and educate parents about the importance of urgent evaluation in the Emergency Department to reduce the likelihood of an orchiectomy.