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• W2051233413 abstract "No AccessJournal of UrologyPediatric Urology1 Nov 2011Pediatric Testicular Torsion Epidemiology Using a National Database: Incidence, Risk of Orchiectomy and Possible Measures Toward Improving the Quality of Care Lee C. Zhao, Timothy B. Lautz, Joshua J. Meeks, and Max Maizels Lee C. ZhaoLee C. Zhao Department of Urology, Northwestern University, Chicago, Illinois More articles by this author , Timothy B. LautzTimothy B. Lautz Department of General Surgery, Northwestern University, Chicago, Illinois More articles by this author , Joshua J. MeeksJoshua J. Meeks Department of Urology, Northwestern University, Chicago, Illinois More articles by this author , and Max MaizelsMax Maizels Department of Urology, Northwestern University, Chicago, Illinois More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.07.024AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Testicular torsion causes considerable morbidity in the pediatric population but the societal burden is poorly quantified. We determined the modern incidence of testicular torsion as well as the current rates of orchiectomy and attempted testicular salvage, and identified the risk factors for testicular loss. Materials and Methods: A cohort analysis was performed of 2,443 boys (age 1 month to less than 18 years) and 152 newborns who underwent surgery for testicular torsion in the 2000, 2003 and 2006 Healthcare Cost and Utilization Project Kids' Inpatient Database. Patient and hospital characteristics predictive of orchiectomy vs attempted testicular salvage were analyzed. Results: There was a bimodal distribution of testicular torsion with peaks in the first year of life and in early adolescence. The overall mean age ± SD at presentation was 10.6 ± 5.8 years. The estimated yearly incidence of testicular torsion for males younger than 18 years old was 3.8 per 100,000. Orchiectomy was performed in 41.9% of boys undergoing surgery for torsion. The adjusted odds ratio for orchiectomy was highest for children in the youngest age quartile (younger than 10 years old, OR 1.58, 95% CI 1.25–2.00). Additional independent predictors of orchiectomy included Medicaid insurance (OR 1.39, 95% CI 1.14–1.69), black race (OR 1.33, 95% CI 1.04–1.71), nonemergency room admission source (OR 1.97, 95% CI 1.60–2.42) and surgery at a children's hospital or unit (OR 1.64, 95% CI 1.36–1.98). Conclusions: Testicular torsion is uncommon but the rate of orchiectomy is high, especially in the youngest patients. References 1 : Torsion of the testis and allied conditions. Br J Surg1976; 63: 465. Google Scholar 2 : Abnormalities of the testes and scrotum and their surgical management. In: . Edited by . Philadelphia: Saunders-Elsevier2007: 4592. Google Scholar 3 : Late hormonal function after testicular torsion. J Pediatr Surg2010; 45: 411. Google Scholar 4 : Late hormonal levels, semen parameters, and presence of antisperm antibodies in patients treated for testicular torsion. J Androl2007; 28: 528. Google Scholar 5 : Testicular torsion: late results with special regard to fertility and endocrine function. J Urol1980; 124: 375. Link, Google Scholar 6 : A 19-year review of paediatric patients with acute scrotum. Scand J Surg2007; 96: 62. Google Scholar 7 : Testicular torsion: direction, degree, duration and disinformation. J Urol2003; 169: 663. Link, Google Scholar 8 : Testicular torsion and risk factors for orchiectomy. Arch Pediatr Adolesc Med2005; 159: 1167. Google Scholar 9 : Healthcare Cost and Utilization Project (HCUP). 2000, 2003, and 2006. Agency for Healthcare Research and Quality, Rockville, Maryland http://www.hcup-us.ahrq.gov/kidoverview.jsp. Accessed April 14, 2011. Google Scholar 10 : http://www.census.gov/popest/national/asrh/NC-EST2006-sa.html. Accessed April 14, 2011. Google Scholar 11 : http://www.childrenshospitals.net/. Accessed January 19, 2010. Google Scholar 12 : Testicular salvage and age-related delay in the presentation of testicular torsion. J Urol1989; 142: 746. Link, Google Scholar 13 : Hospital- and patient-level characteristics and the risk of appendiceal rupture and negative appendectomy in children. JAMA2004; 292: 1977. Google Scholar 14 : Incidence and trends of pediatric ovarian torsion hospitalizations in the United States, 2000-2006. Pediatrics2010; 125: 532. Google Scholar 15 : Testicular torsion: most delay occurs outside hospital. Ann R Coll Surg Engl1998; 80: 169. Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byChun B, Colaco M, Fox J, Cannon G, Schneck F, Chaudhry R and Villanueva J (2022) Salvage Surgery Rates for Pediatric Testicular Torsion: Comparison of the Pre- and Post-Quality Metric ErasJournal of Urology, VOL. 208, NO. 2, (441-447), Online publication date: 1-Aug-2022.Duquesne I, Pinar U, Dang V, Mauger de Varennes A, Benali N, Berchiche W, Margue G, Gaillard C, Bardet F, Hulin M, Manuguerra A, Plassais C, Wandoren W, Lannes F, Khene Z and Pradere B (2021) Contralateral Orchiopexy at the Time of Urgent Scrotal Exploration—Is It Safe? A Propensity Score Matched Analysis from the TORSAFUF CohortJournal of Urology, VOL. 206, NO. 6, (1461-1468), Online publication date: 1-Dec-2021.Schlomer B, Keays M, Grimsby G, Granberg C, DaJusta D, Menon V, Ostrov L, Sheth K, Hill M, Sanchez E, Harrison C, Jacobs M, Huang R, Burgu B, Hennes H and Baker L (2017) Transscrotal Near Infrared Spectroscopy as a Diagnostic Test for Testis Torsion in Pediatric Acute Scrotum: A Prospective Comparison to Gold Standard Diagnostic Test StudyJournal of Urology, VOL. 198, NO. 3, (694-701), Online publication date: 1-Sep-2017.Samson P, Hartman C, Palmerola R, Rahman Z, Siev M, Palmer L and Ghorayeb S (2016) Ultrasonographic Assessment of Testicular Viability Using Heterogeneity Levels in Torsed TesticlesJournal of Urology, VOL. 197, NO. 3 Part 2, (925-930), Online publication date: 1-Mar-2017.Bayne C, Gomella P, DiBianco J, Davis T, Pohl H and Rushton H (2016) Testicular Torsion Presentation Trends before and after Pediatric Urology Subspecialty CertificationJournal of Urology, VOL. 197, NO. 2, (507-515), Online publication date: 1-Feb-2017.Sheth K, Keays M, Grimsby G, Granberg C, Menon V, DaJusta D, Ostrov L, Hill M, Sanchez E, Kuppermann D, Harrison C, Jacobs M, Huang R, Burgu B, Hennes H, Schlomer B and Baker L (2016) Diagnosing Testicular Torsion before Urological Consultation and Imaging: Validation of the TWIST ScoreJournal of Urology, VOL. 195, NO. 6, (1870-1876), Online publication date: 1-Jun-2016.Martin A and Rushton H (2014) The Prevalence of Bell Clapper Anomaly in the Solitary Testis in Cases of Prior Perinatal TorsionJournal of Urology, VOL. 191, NO. 5S, (1573-1577), Online publication date: 1-May-2014.Chen J, Lin Y and Yang W (2013) Diurnal Temperature Change is Associated with Testicular Torsion: A Nationwide, Population Based Study in TaiwanJournal of Urology, VOL. 190, NO. 1, (228-233), Online publication date: 1-Jul-2013.Altinkilic B, Pilatz A and Weidner W (2012) Detection of Normal Intratesticular Perfusion Using Color Coded Duplex Sonography Obviates Need for Scrotal Exploration in Patients with Suspected Testicular TorsionJournal of Urology, VOL. 189, NO. 5, (1853-1858), Online publication date: 1-May-2013.Barbosa J, Tiseo B, Barayan G, Rosman B, Torricelli F, Passerotti C, Srougi M, Retik A and Nguyen H (2012) Development and Initial Validation of a Scoring System to Diagnose Testicular Torsion in ChildrenJournal of Urology, VOL. 189, NO. 5, (1859-1864), Online publication date: 1-May-2013. Volume 186Issue 5November 2011Page: 2009-2013 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsepidemiologyspermatic cord torsionsocioeconomic factorsMetricsAuthor Information Lee C. Zhao Department of Urology, Northwestern University, Chicago, Illinois More articles by this author Timothy B. Lautz Department of General Surgery, Northwestern University, Chicago, Illinois More articles by this author Joshua J. Meeks Department of Urology, Northwestern University, Chicago, Illinois More articles by this author Max Maizels Department of Urology, Northwestern University, Chicago, Illinois More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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