Prognostic Factors for Pediatric Testicular Torsion Outcomes

ABSTRACT

@#Introduction: Testicular torsion is a urological emergency causing spermatic cord twisting. Delayed management can cause poor outcome, i.e. orchiectomy. Here, we investigated several prognostic factors, including age, onset, clinical symptoms, leukocyte count, for testicular torsion outcomes (orchiectomy vs. orchiopexy) in children in Indonesia. Methods: A retrospective review of 23 patients with testicular torsion who underwent scrotal exploration from July 2013 to November 2018 at our institution was done. Results: The age at testicular torsion diagnosis was 12.8 (interquartile range, 4.6-15.1) years. Only fever showed strong significant prognostic factor for orchiectomy (OR=20; 95% CI=1.6 – 248; p=0.017), while other factors were not, with p-value of 0.54, 1.0, 1.0, 0.19, 1.0, 0.62, 0.62, 0.58, and 0.62, for age, onset, scrotal pain, abdominal pain, hyperemia, edema, nausea, vomitus and white blood cells count, respectively. Furthermore, logistic regression test also revealed that fever is a strong prognostic factor for orchiectomy (OR=22.6; 95% Cl=1.3 – 394.2; p=0.033). Conclusion: The patient with testicular torsion with fever tends to undergo orchiectomy. Further multicenter studies with a larger sample size are necessary to confirm our findings.