Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2024; 12(7): 1251-1259
Published online Mar 6, 2024. doi: 10.12998/wjcc.v12.i7.1251
Clinical characteristics of testicular torsion and factors influencing testicular salvage in children: A 12-year study in tertiary center
Xiang-Hui Gang, Yuan-Yuan Duan, Bin Zhang, Zheng-Gan Jiang, Rong Zhang, Jun Chen, Xiang-Yu Teng, Duo-Bing Zhang
Xiang-Hui Gang, Bin Zhang, Zheng-Gan Jiang, Rong Zhang, Jun Chen, Duo-Bing Zhang, Department of Urology, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui Province, China
Yuan-Yuan Duan, Department of Ultrasound Diagnosis, Suzhou Hospital Affiliated to Anhui Medical University, Suzhou 234000, Anhui Province, China
Xiang-Yu Teng, Department of Urology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230000, Anhui Province, China
Co-first authors: Xiang-Hui Gang and Yuan-Yuan Duan.
Author contributions: Gang XH study conception and design, analysis and data interpretation, drafting of the manuscript, and critical revision; Duan YY, Jiang ZG and Teng XY study conception and design, data acquisition, and critical revision; Zhang B, Zhang R, and Chen J data acquisition, analysis, interpretation, and critical revision; Zhang DB study conception and design, analysis and data interpretation, drafting of the manuscript, and critical revision.
Supported by Anhui Province Translational Medicine Research Fund Project, No. 2021zhyx-C59 and No. 2021zhyx-C75.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Anhui Medical University Suzhou Hospital Institutional Review Board, Approval No. A2023006.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Duo-Bing Zhang, MD, Academic Research, Surgeon, Department of Urology, Suzhou Hospital Affiliated to Anhui Medical University, No. 299 Bianhe Middle Road, Suzhou 234000, Anhui Province, China. zhangduobingsz@126.com
Received: November 26, 2023
Peer-review started: November 26, 2023
First decision: December 29, 2023
Revised: January 9, 2024
Accepted: February 4, 2024
Article in press: February 4, 2024
Published online: March 6, 2024
Processing time: 95 Days and 18.7 Hours
Abstract
BACKGROUND

Testicular torsion is the most common acute scrotum worldwide and mainly occurs in children and adolescents. Studies have demonstrated that the duration of symptoms and torsion grade lead to different outcomes in children diagnosed with testicular torsion.

AIM

To predict the possibility of testicular salvage (TS) in patients with testicular torsion in a tertiary center.

METHODS

We reviewed the charts of 75 pediatric patients with acute testicular torsion during a 12-year period from November 2011 to July 2023 at the Suzhou Hospital of Anhui Medical University. Univariate and multivariate logistic regression analyses were used to determine independent predictors of testicular torsion. The data included clinical findings, physical examinations, laboratory data, color Doppler ultrasound findings, operating results, age, presenting institution status, and follow-up results.

RESULTS

Our study included 75 patients. TS was possible in 57.3% of all patients; testicular torsion occurred mostly in winter, and teenagers aged 11-15 years old accounted for 60%. Univariate logistic regression analyses revealed that younger age (P = 0.09), body mass index (P = 0.004), torsion angle (P = 0.013), red blood cell count (P = 0.03), neutrophil-to-lymphocyte ratio (P = 0.009), and initial presenting institution (P < 0.001) were associated with orchiectomy. In multivariate analysis, only the initial presenting institution predicted TS (P < 0.05).

CONCLUSION

The initial presenting institution has a predictive value for predicting TS in patients with testicular torsion. Children with scrotal pain should be admitted to a tertiary hospital as soon as possible.

Keywords: Testicular torsion, Testicular salvage, Pediatrics, Predictors, Case report

Core Tip: We retrospectively collected cases of testicular torsion surgery in adolescents at a tertiary hospital and found that the initial visit to a non tertiary hospital may delay the patient's diagnosis and optimal surgical time.