Abstract
BACKGROUND: Testicular torsion (TT) is a urological emergency requiring prompt intervention to prevent irreversible damage to the testicle. OBJECTIVE: This study aims to assess trends in men's TT referrals, diagnostic evaluation through Doppler sonography (DS) scan, symptoms before surgery, orchidectomy rates, and TT laterality in relation to age and seasons of the year. METHODS: This observational retrospective cohort study included all patients treated for TT at King Abdullah University Hospital between 2009 and 2021. Patients underwent DS, scrotal exploration, orchidopexy, or orchidectomy. Data collected encompassed patient demographics, admission date, duration of symptoms, laterality, and surgical intervention. RESULTS: Our study consisted of 308 TT patients between the ages of 10 and 33. Approximately 194 (63%) patients who were taken to the hospital for an average of 47 hours got an orchidectomy. Although the majority of patients received orchidopexy within 72 hours of detorsion and orchidopexy, five patients (3.6%) required reperfusion following detorsion and orchidopexy. A total of 112 individuals (36.4%) underwent bilateral orchidopexy, which lasted anywhere from 9 to 26 hours, whereas 194 (63%) patients underwent orchidectomy, which lasted anything from 40 to 264 hours (p < 0.001). The prevalence of right-sided TT increases by 6% per year with age (p = 0.047). CONCLUSIONS: This study found a high association between the amount of recoverable testicular tissue and the duration of symptoms before surgery. Even after 72 hours, it is still possible to salvage the testicles, even though the success rate reduces from 75% within 24 hours to 3.6% beyond that. Additionally, elderly individuals are more likely to experience right-sided torsion. Seasonal variation was evident, with the highest incidence of TT occurring during winter months, suggesting potential environmental or physiological triggers.