Can the Effect of Torsion Duration Change in the Decision of Orchiectomy in Children with Testicular Torsion?

Objective: Acute scrotum is especially important in terms of testicular torsion that causes organ loss. In this study, some variables of the patients [age, duration of admission, scrotal Doppler ultrasonography (SDU) application time, time to surgery, testicular appearance during surgery] in cases who were found to have testicular torsion over a four-year period were evaluated to evaluate the factors affecting orchiectomy.
Methods: The study sample consisted of patients who applied to the hospital with the complaint of acute scrotal pain and/or swelling between January 2017 and December 2020.
Results: It was determined that 199 patients with scrotal pain and/or swelling were admitted to the hospital within the specified period. The mean age of patients with testicular torsion (n=26) was 8.93±5.25 years. In the testicular torsion group, the time elapsed between the onset of patients’ complaints and admission to the hospital was calculated, depending on the type of operation. While this period was 80.18±16.32 h in patients who underwent orchiectomy, it was determined as 17.46±8.75 h in patients whose testis was left in place. A significant difference was found between the onset of complaints and the time to hospital admission in cases where orchiectomy was performed and in cases where the testis was left in place.
Conclusion: As a result, in the case of acute scrotum, the time from the onset of the patient's complaints to hospital admission is important. The application of SDU to all acute scrotum cases may provide early detection of testicular torsion. In the literature, it has been stated that the chance of protection is high for testicles that are caught within 6 h, but in our series, testes that were torsion for 17.46±8.75 h could be preserved.