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Cut-off time for surgery and prediction of orchiectomy in spermatic cord torsion: a retrospective multicentric study over 15 years.
- Source :
- World Journal of Urology; Dec2023, Vol. 41 Issue 12, p3789-3794, 6p
- Publication Year :
- 2023
-
Abstract
- Purpose: Cut-off time to avoid orchiectomy relies on small series of patients. The objective was to determine the cut-off time to avoid orchiectomy in torsion of the spermatic cord in a large cohort. Methods: We performed a retrospective multicenter study (TORSAFUF cohort) of patients with suspected spermatic cord torsion between 2005 and 2019. All patients aged > 12 years who were suspected of having a torsion of the spermatic cord in 14 University Hospitals in France were included (n = 2986). Patients for whom data on pain duration were not available (n = 923) or for whom the final diagnosis was not torsion of the spermatic cord (n = 807) were excluded. The primary outcome was orchiectomy. The secondary outcomes were testicular survival time and the prediction of orchiectomy with the duration of pain. Results: 1266 patients were included with an orchiectomy rate of 12% (150 patients). The mean age was 21.5 years old in the salvage group and 23.7 years old in the orchiectomy group (p = 0.01), respectively. The median time from the onset of pain to surgery was 5.5 (IQR = 5) hours in the salvage group and 51.1 (IQR = 70) hours in the orchiectomy group (p < 0.0001). The risk of orchiectomy increased after a time cut-off of 6 h 30. A delay of 15 h 30 in pain duration was found to predict orchiectomy (sensitivity: 0.81; specificity: 0.87). Conclusions: Pain duration can predict the probability of salvaging the testicles and performing orchiectomy. Rapid intervention should be recommended, regardless of the time elapsed from the onset of pain. [ABSTRACT FROM AUTHOR]
- Subjects :
- SPERMATIC cord torsion
CASTRATION
SURGERY
TESTIS
Subjects
Details
- Language :
- English
- ISSN :
- 07244983
- Volume :
- 41
- Issue :
- 12
- Database :
- Complementary Index
- Journal :
- World Journal of Urology
- Publication Type :
- Academic Journal
- Accession number :
- 173963801
- Full Text :
- https://doi.org/10.1007/s00345-023-04671-x