Clinical Outcomes of Acute Testicular Torsion Between Prepubertal and Postpubertal Males

In this study, the authors evaluated the relationship between age at presentation and likelihood of testicular salvage among children presenting with testicular torsion. Patients were classified according to age (birth–12 years and 13–18 years) to correspond with typical pre- and post-pubertal presentation. Older patients were more likely to present with testicular pain (98% vs 79%), whereas younger patients were more likely to present with abdominal pain (27% vs 10%). Median time from arrival in the ER to surgery was 49 minutes shorter among older children, and orchiectomy rates were much lower (24% vs 42%) among children aged 13 to 18 years, perhaps related to longer but nonsignificantly different median symptom duration (12 hours for ages birth–12 years vs 9.5 hours for ages 13–18). On adjusted analysis, older age (OR, 0.84) was associated with lower orchiectomy rates, with a trend towards an association between longer symptom duration and time between presentation and surgery.

Taken together, these results suggest that delayed diagnosis in younger patients contributes to increased orchiectomy rates. A greater index of suspicion for torsion in young patients presenting with abdominal pain may expedite diagnosis and management.

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