Characteristics and management of testicular torsion patients presented to a tertiary care hospital: A prospective cohort study

Background: Testicular torsion is a surgical emergency that occurs when twisting of the testicle around the spermatic cordtakes place. To our knowledge there are no regional manuscripts discussing testicular torsion.Aim: The current work aimed at filling this gap by studying the characteristics and management of patients presented withtesticular torsion.Patients and Methods: Study subjects were recruited from patients presented to Kasr Al-Ainy emergency departmentcomplaining of acute testicular pain for variable duration in a period of 6 months. A total of 33 patients were included.Results: The mean presenting age was 19.56 years (±6.94). Orchidectomy was done in 18 cases (54.5%) with the meanduration of torsion 6.43 hours ± 4.05. Orchidopexy was performed in 15 cases (45.4%) with the mean duration of torsion 28.56hours ± 11.08. There was a significant correlation between duration of torsion and fate of the testis. No statistically significantcorrelation between degree of torsion and fate of testis. In all cases, the type of torsion was intravaginal. Reactive hydrocelewas visualized in 15 patients, 11 of them (73.3%) underwent orchiopexy and 4 cases (26.7%) underwent orchiectomy. Nohydrocele could be visualized in 18 cases, 14 of them (77.8%) underwent orchiectomy and 4 cases (22.2%) underwentorchiopexy. A significant correlation was found between presence of reactive hydrocele and salvage of the testis.Conclusion: The time between the onset of pain and surgical intervention is the most important factor in prediction of the fateof the testis, in preoperative ultrasound, heterogeneity and absence of a reactive hydrocele were predictive factors of organloss but this is not a reason to delay surgery as some patients did not have.