How to Reduce Time Delays in Presentation and Treatment of Testicular Torsion; the Role of Public and Practitioners Education


ABSTRACT:BACKGROUND: Testicular torsion (TT) requires prompt diagnosis and treatment to avoid testicular Loss. Most studies have focused on the ideal work up to rule TT out in cases of acute scrotum. A long response time to the scrotal pain was related to high orchidectomy rate during surgery for acute torsion.OBJECTIVE:We attempted here to highlight the causes behind high orchidectomy rate during the surgery for testicular torsion and the advices to decrease this problem.PATIENTS AND METHODS: Surgical exploration which was done for suspected testicular torsion in 50 consecutive males with their age (range 1-20 years. All patients were evaluated with detailed history, physical examination and Basic Laparotory investigations, some patients underwent scrotal ultrasound scan with color-Doppler preoperatively when possible. Patient age, site of pain, duration of symptoms, ultrasound finding, approximate time from admission to surgery, operative findings, and type of the operation and causes of delay for orchidectomy group were recorded.RESULTS: Intra operative Testicular torsion was documented in 36 patients, orchidectomy and orchidopexy was performed equally, Delays to reach the hospital for more than 4 hours after the onset of pain significantly associated with increase the risk of orchidectomy .The risk of orchidectomy significantly increased with increased patient age. Parents neglect appear the most important cause for small age group while self ignorance, social fear and false medical advices for older ages.CONCLUSION: A long response time to the scrotal pain and a high orchidectomy rate were exposed by this study. This was thought to be due to ignorance, which could be eliminated through public education.