Pediatric Testicular Torsion: Does Patient Transfer Affect Time to Intervention or Surgical Outcomes at a Rural Tertiary Care Center?

Overview

Journal BMC Urol

Publisher Biomed Central

Specialty Urology

Date 2019 May 19

PMID 31101044

Citations 5

Authors

Tyler Overholt

Morris Jessop

John Barnard

Osama Al-Omar

Affiliations

Soon will be listed here.

Abstract

Background: Testicular torsion (TT) is a urologic emergency that requires prompt surgical intervention. In rural Appalachia, patients are often transferred from surrounding communities due to lack of urologic care. We hypothesized that those transferred would have delayed intervention and higher rates of orchiectomy when compared to those who presented directly to our hospital.

Methods: We performed a retrospective review of patient charts with an ICD-9 diagnosis of TT from 2008 to 2016. Patients met inclusion criteria if diagnosis was confirmed by operative exploration. We compared rate of testicular loss and time until surgical intervention between groups.

Results: Twenty-three patients met inclusion criteria (12 transferred, 11 direct). Patient demographics did not significantly differ between groups. Transferred patients had a higher orchiectomy rate (33% v 22%,p = 0.41) although this was not statistically significant. Time to surgery from symptom onset was significantly longer in those transferred (12.9 h) compared to those not transferred (6.9 h, p = 0.02). Distance of transfer was not correlated with time of delay (r = 0.063).

Conclusions: Transferred patients with TT have numerically higher rates of orchiectomy which may reach significance in an appropriately powered study, and relative delays in surgical intervention. This study highlights the need for improved access to urologic care in rural areas.

Citing Articles

Factors Determining Testicular Torsion and Consequent Orchiectomy in Pediatric Patients Presenting With Scrotal Pain.

Yen C, Chang Y, Ming Y, Gau C, Wu C, Lee J Pediatr Emerg Care. 2023; 39(10):744-750.

PMID: 37624776 PMC: 10547102. DOI: 10.1097/PEC.0000000000003037.

The diagnosis and treatment of testicular torsion in children with non-scrotal initial symptoms.

Mao C, Cao Y, Liu X, Peng B, Chu H, Deng Q Front Pediatr. 2023; 11:1176345.

PMID: 37397154 PMC: 10311083. DOI: 10.3389/fped.2023.1176345.

Impact of Distance From the Hospital and Patient Transfer on Pediatric Testicular Torsion Outcomes.

Shields L, Daniels M, Peppas D, Rosenberg E Cureus. 2022; 14(5):e25284.

PMID: 35755550 PMC: 9225051. DOI: 10.7759/cureus.25284.

Patient transfer influences the prognosis of pediatric patients operated for testicular torsion: a single-center experience.

Wang J, Deng Y, Gu N, Zhu H, Zhu X, Huang L Transl Pediatr. 2021; 10(3):494-501.

PMID: 33850808 PMC: 8039783. DOI: 10.21037/tp-20-287.

Point-of-care ultrasonography for the diagnosis of testicular torsion: a practical resident curriculum.

Stringer L, Cocco S, Jiang A, Chan E, Myslik F, Brahm G Can J Surg. 2021; 64(2):E191-E195.

PMID: 33739804 PMC: 8064263. DOI: 10.1503/cjs.019119.

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