Yecies T, et al. - This paper incorporated the determination of the rate at which testicular torsion occurred in a lateral direction. Researchers also attempted to detect any predictors of the direction of testicular rotation and orchiectomy. The occurrence of testicular rotation was noted in a lateral direction, in 46% of the cases. Findings suggested that the lateral manual detorsion ought to be performed only with awareness of the potential for increasing the degree of testicular rotation. This study also revealed new independent predictors of testicular salvage.

Methods

• Researchers re-analyzed 104 cases of emergent scrotal exploration performed for testicular torsion by 3 pediatric urologists from 2003-2017.
• The exclusion criteria consisted of patients with neonatal torsion, negative scrotal exploration, or exploration for presumed intermittent testicular torsion.
• Univariable logistic regression assisted in incestigating if any factors speculated the direction of testicular rotation.
• In order to determine the predictors of testicular salvage, authors used univariable and multivariable logistic regression.

Results

• Among the acute testicular torsion cases, information was available regarding the direction of testicular rotation in 81 patients.
• In 38 cases (46%), the occurrence of lateral testicular rotation was noted.
• Findings did not disclose any factors to be speculative of the direction of torsion.
• In 50/104 cases (48%), orchiectomy was carried out for testicular non-viability.
• The univariable analysis revealed that younger age (p=.002), absence of gastrointestinal symptoms (p=0.02), time to exploration (p < 0.001), testicular size differential on ultrasound (p=.002), absence of hydrocele (p=0.01), abnormal ultrasound echotexture (p < 0.001), and degree of torsion (p=0.04) exhibited a connection with orchiectomy.
• All predictors of orchiectomy were statistically prominent on multivariable analysis, with the exclusion of absence of gastrointestinal symptoms.