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- Title
Cut-off time for surgery and prediction of orchiectomy in spermatic cord torsion: a retrospective multicentric study over 15 years.
- Authors
Seizilles de Mazancourt, Emilien; Khene, Zinnedine; Sbizerra, Marc; Kaulanjan, Kevin; Plassais, Caroline; Bardet, Florian; Pinar, Ugo; Duquesne, Igor; Margue, Gaelle; Ali Benali, Nadia; Berchiche, William; Gaillard, Charles; Wandoren, William; Manuguerra, Anthony; Dang, Van Thi; Mauger de Varennes, Anne; Hulin, Maud; Gaillard, Victor; Dominique, Ines; Michiels, Clement
- 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.
- Subjects
FRANCE; SPERMATIC cord torsion; CASTRATION; SURGERY; TESTIS
- Publication
World Journal of Urology, 2023, Vol 41, Issue 12, p3789
- ISSN
0724-4983
- Publication type
Article
- DOI
10.1007/s00345-023-04671-x