A retrospective multicentric analysis on testicular torsion: is there still something to learn?
| Autor: | Daniele Tiscione, F. Dal Moro, A. Morlacco, F. Migliozzi, Carolina D'Elia, Guglielmo Zeccolini, L. Bettin, F. Goffo, Fabio Vianello, Nicolò Leone, Massimo Iafrate, Antonio Amodeo, Luca Frazza, Giordana Ferraioli, Daniele Vecchio, Carlo Trombetta |
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| Přispěvatelé: | Leone, N., Morlacco, A., D'Elia, C., Amodeo, A., Vecchio, D., Tiscione, D., Zeccolini, G., Ferraioli, G., Frazza, L. A., Bettin, L., Congregalli, A., Migliozzi, F., Liguori, G., Trombetta, C., Dal Moro, F., Iafrate, M. |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Urology Acute scrotum 030232 urology & nephrology Ischemia Testicular pain 030204 cardiovascular system & hematology lcsh:RC870-923 lcsh:RC254-282 03 medical and health sciences 0302 clinical medicine Testis medicine Epididymo orchitis Testicular torsion surgical exploration Humans epididymo-orchiti Retrospective Studies Spermatic Cord Torsion business.industry General surgery lcsh:Diseases of the genitourinary system. Urology lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease testicular torsion Surgery Nephrology testicular pain Scrotum epididymo-orchitis medicine.symptom business Orchiectomy |
| Zdroj: | European Urology Open Science, Vol 19, Iss, Pp e2078-(2020) |
| ISSN: | 2168-1813 |
| Popis: | Introduction and aim: Speedy diagnosis are mandatory in testicular torsion, nevertheless some cases of irreversible ischemia still occur. In this study we analysed the results of patients undergoing surgical exploration for acute scrotum. Materials and methods: A multicentric retrospective clinical evaluation was carried out on patients who underwent urgent scrotal exploration at 12 different departments in North-Eastern Italy. Data included complete anagraphic information, clinical presentation, numeric pain rating scale, previous testicular surgery, Doppler serial ultrasonography (US) evaluation and concordance with surgical findings, testicular mobility, surgical treatment, staged or concurrent treatment of the contralateral gonad. Statistical analysis was conducted both for descriptive and inferential statistics with SPSS v26. Results: Three hundred and sixty-eight cases were collected between January 2010 and June 2019. The time between symptom onset and ER access time was within 6 h in majority of patients. However, 17.4% of subject presented after more than 12 h. In patients undergoing US, this showed signs of ischemia in 237 patients (77.2%) and normal vascularisation in 70 (22.8%) of whom 26 had signs of testicular torsion at surgical exploration. Overall, the US data were concordant with the surgical findings in 254 cases (82.7%). A significant association was found between time-to-evaluation and time-to-treatment and the need for orchiectomy (p < 0.01). Conclusion: Testicular torsion management is still challenging in terms of time-saving decision making. Scrotal US is helpful, but even in the contemporary its sensitivity is low era in a non-neglectable number of cases, therefore surgical exploration is warranted in acute scrotum when torsion cannot be ruled out, even when US shows vascularisation. |
| Databáze: | OpenAIRE |
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