Abstract | OBJECTIVE: To determine whether there is justification for a policy of conservative management of acute scrotal emergencies, based on the ability to exclude a twisted testicle or the assumption that there is a "missed torsion' when the duration of symptoms is prolonged. PATIENTS AND METHODS: The case notes of 209 consecutive emergency scrotal explorations, carried out in one district general hospital over a 7-year period, were reviewed. The decision to operate was based solely on a clinical diagnosis, with no information from additional radiological investigations. RESULTS: The commonest finding was testicular torsion (39.5%) with an orchidectomy rate of 22%. Only 5% of scrotal torsions occurred in patients < 12 years of age, whereas 26% occurred in those > 20 years of age. In five of 82 cases (6%) of confirmed testicular torsion, the surgeon did not consider this the most likely diagnosis. With a pain duration of < 16 h, 89% of testes were salvaged, but with pain for > 16 h this decreased to 25%. In three cases the testis was viable after pain had been present for > 24 h. CONCLUSION: In the absence of supportive radiological investigations, a small but significant number of twisted testes will be missed if conservative management is adopted.
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Authors | N A Watkin, N A Reiger, C U Moisey |
Journal | British journal of urology
(Br J Urol)
Vol. 78
Issue 4
Pg. 623-7
(Oct 1996)
ISSN: 0007-1331 [Print] England |
PMID | 8944521
(Publication Type: Journal Article)
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Topics |
- Acute Disease
- Adolescent
- Age Distribution
- Decision Making
- Genital Diseases, Male
(diagnosis, surgery)
- Humans
- Male
- Pain
(etiology)
- Scrotum
(surgery)
- Sensitivity and Specificity
- Spermatic Cord Torsion
(surgery)
- Treatment Outcome
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