Mp72-19 Characterizing the Time to Assessment and Surgical Intervention for Pediatric Testicular Torsion and Identifying Areas Requiring Qualitative Improvement

You have accessJournal of UrologyPediatrics VII (MP72)1 May 2024MP72-19 CHARACTERIZING THE TIME TO ASSESSMENT AND SURGICAL INTERVENTION FOR PEDIATRIC TESTICULAR TORSION AND IDENTIFYING AREAS REQUIRING QUALITATIVE IMPROVEMENT Tara Sweeney, Margaret Stroud, Jessi Fernandez Reyes, and Austin Creviston Tara SweeneyTara Sweeney , Margaret StroudMargaret Stroud , Jessi Fernandez ReyesJessi Fernandez Reyes , and Austin CrevistonAustin Creviston View All Author Informationhttps://doi.org/10.1097/01.JU.0001009572.60675.69.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Testicular torsion is a surgical emergency that may result in testis loss. Prior studies have been done to improve time to surgical detorsion by utilizing multidisciplinary checklists to expedite evaluation by urology but few on optimizing the process from urologist evaluation to surgical start time. Our aim is to optimize the time to treatment for pediatric patients with suspected testicular torsion at the Medical University of South Carolina (MUSC). METHODS: We conducted a retrospective chart review on 64 pediatric patients who presented to our pediatric emergency department (ED) from the years 2018-2023 that underwent intervention for concerns for testicular torsion. The average times to patient presentation, scrotal ultrasound, urology consult, and surgical start time were assessed. The type of surgical exploration was also assessed. A student's T-test was conducted to compare the average time points within the orchiectomy group to the orchiopexy group. RESULTS: The average time from patient presentation in the ED to ultrasound was 58 minutes with time from presentation to urology consultation averaging 77 minutes. The average time to surgical start was 246 minutes with an average of 174 minutes for patient to be taken to the operating room from the time of urology consultation. There was a significantly longer duration of time between patient presentation to time of urology consultation in the orchiectomy group compared to the orchiopexy group (109 minutes vs. 65 minutes) (p<0.05), and from patient presentation to surgical start in the orchiectomy group compared to the orchiopexy group (364 minutes vs. 176 minutes) (p<0.01). CONCLUSIONS: This further supports that prolonged times to surgical detorsion may contribute to patient outcome. It is of note that patients who underwent orchiectomy took on average 45 hours to present to the MUSC ED compared to an average of 11 hours for patients who ultimately underwent orchiopexy. Treatment times for patients who underwent orchiectomy may have been biased by a lack of urgency in delayed presenters. Aside from difference in outcome, time to urology consult and time from consult to surgical start time is greater than 2 hours therefore providing a source for quality improvement. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1179 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Tara Sweeney More articles by this author Margaret Stroud More articles by this author Jessi Fernandez Reyes More articles by this author Austin Creviston More articles by this author Expand All Advertisement PDF downloadLoading ...