Characteristics and management of testicular torsion patients presented to a tertiary care hospital: A prospective cohort study

Document Type : Original Article


1 Department of Andrology and Sexual Medicine, Facultyof medicine, Cairo University

2 Department of Andrology and Sexual Medicine, Faculty of medicine, Cairo University

3 Ministry of Health and Population, Egypt.

4 Department of Andrology and Sexual medicine, Faculty of Medicine, Cairo University


Background: Testicular torsion is a surgical emergency that occurs when twisting of the testicle around the spermatic cord
takes place. To our knowledge there are no regional manuscripts discussing testicular torsion.
Aim: The current work aimed at filling this gap by studying the characteristics and management of patients presented with
testicular torsion.
Patients and Methods: Study subjects were recruited from patients presented to Kasr Al-Ainy emergency department
complaining of acute testicular pain for variable duration in a period of 6 months. A total of 33 patients were included.
Results: The mean presenting age was 19.56 years (±6.94). Orchidectomy was done in 18 cases (54.5%) with the mean
duration of torsion 6.43 hours ± 4.05. Orchidopexy was performed in 15 cases (45.4%) with the mean duration of torsion 28.56
hours ± 11.08. There was a significant correlation between duration of torsion and fate of the testis. No statistically significant
correlation between degree of torsion and fate of testis. In all cases, the type of torsion was intravaginal. Reactive hydrocele
was visualized in 15 patients, 11 of them (73.3%) underwent orchiopexy and 4 cases (26.7%) underwent orchiectomy. No
hydrocele could be visualized in 18 cases, 14 of them (77.8%) underwent orchiectomy and 4 cases (22.2%) underwent
orchiopexy. A significant correlation was found between presence of reactive hydrocele and salvage of the testis.
Conclusion: The time between the onset of pain and surgical intervention is the most important factor in prediction of the fate
of the testis, in preoperative ultrasound, heterogeneity and absence of a reactive hydrocele were predictive factors of organ
loss but this is not a reason to delay surgery as some patients did not have.