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Scrotal exploration for acute scrotal pain: a 10-year experience in two tertiary referral paediatric units.
Scand J Urol. 2013 Oct; 47(5):418-22.SJ

Abstract

OBJECTIVE

Acute scrotal pain is a common presentation to the paediatric emergency department. Testicular torsion is one of the most common causes of acute scrotal pain. Testicular torsion is a surgical emergency requiring immediate surgical exploration to prevent permanent testicular damage or loss. The aim of this study was to determine the surgical outcome of all scrotal explorations and to assess the use of colour Doppler ultrasound (CDUS) in the assessment of acute scrotal pain in two tertiary referral paediatric units.

MATERIAL AND METHODS

A retrospective review of a prospectively maintained database was carried out for all scrotal explorations between 1999 and 2010.

RESULTS

In total, 155 scrotal explorations were carried out for acute scrotal pain. The mean age was 9.1 years (range 0-15 years). The pathology in 46.5% (n = 72) was testicular torsion, 30.3% (n = 47) were torsion of a testicular appendage, 16.1% (n = 25) were epididymitis, 3.3% (n = 5) had no obvious pathology identified and other pathology accounted for 4%. There was a significant difference in age of presentation between those with testicular torsion and those with torsion of a testicular appendage (9 vs 10 years, p = 0.0074). CDUS was performed by a trained radiologist on 40 patients. Overall sensitivity, specificity, positive predictive value and negative predictive value for CDUS predicting testicular torsion were 96.9%, 88.9%, 96.9% and 89%, respectively. Overall, 36 patients (23%) with acute scrotal pain (50% of patients in the group with confirmed testicular torsion at exploration) required orchidectomy.

CONCLUSION

This study supports the practice of immediate surgical exploration with a clinical suspicion of testicular torsion in a paediatric population.

Authors+Show Affiliations

Department of Paediatric Surgery and Urology, Our Lady's Children's Hospital, Crumlin , Dublin , Ireland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23281617

Citation

Nason, Gregory J., et al. "Scrotal Exploration for Acute Scrotal Pain: a 10-year Experience in Two Tertiary Referral Paediatric Units." Scandinavian Journal of Urology, vol. 47, no. 5, 2013, pp. 418-22.
Nason GJ, Tareen F, McLoughlin D, et al. Scrotal exploration for acute scrotal pain: a 10-year experience in two tertiary referral paediatric units. Scand J Urol. 2013;47(5):418-22.
Nason, G. J., Tareen, F., McLoughlin, D., McDowell, D., Cianci, F., & Mortell, A. (2013). Scrotal exploration for acute scrotal pain: a 10-year experience in two tertiary referral paediatric units. Scandinavian Journal of Urology, 47(5), 418-22. https://doi.org/10.3109/00365599.2012.752403
Nason GJ, et al. Scrotal Exploration for Acute Scrotal Pain: a 10-year Experience in Two Tertiary Referral Paediatric Units. Scand J Urol. 2013;47(5):418-22. PubMed PMID: 23281617.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Scrotal exploration for acute scrotal pain: a 10-year experience in two tertiary referral paediatric units. AU - Nason,Gregory J, AU - Tareen,Farhan, AU - McLoughlin,Danielle, AU - McDowell,Dermot, AU - Cianci,Fiona, AU - Mortell,Alan, Y1 - 2013/01/03/ PY - 2013/1/4/entrez PY - 2013/1/4/pubmed PY - 2014/10/4/medline SP - 418 EP - 22 JF - Scandinavian journal of urology JO - Scand J Urol VL - 47 IS - 5 N2 - OBJECTIVE: Acute scrotal pain is a common presentation to the paediatric emergency department. Testicular torsion is one of the most common causes of acute scrotal pain. Testicular torsion is a surgical emergency requiring immediate surgical exploration to prevent permanent testicular damage or loss. The aim of this study was to determine the surgical outcome of all scrotal explorations and to assess the use of colour Doppler ultrasound (CDUS) in the assessment of acute scrotal pain in two tertiary referral paediatric units. MATERIAL AND METHODS: A retrospective review of a prospectively maintained database was carried out for all scrotal explorations between 1999 and 2010. RESULTS: In total, 155 scrotal explorations were carried out for acute scrotal pain. The mean age was 9.1 years (range 0-15 years). The pathology in 46.5% (n = 72) was testicular torsion, 30.3% (n = 47) were torsion of a testicular appendage, 16.1% (n = 25) were epididymitis, 3.3% (n = 5) had no obvious pathology identified and other pathology accounted for 4%. There was a significant difference in age of presentation between those with testicular torsion and those with torsion of a testicular appendage (9 vs 10 years, p = 0.0074). CDUS was performed by a trained radiologist on 40 patients. Overall sensitivity, specificity, positive predictive value and negative predictive value for CDUS predicting testicular torsion were 96.9%, 88.9%, 96.9% and 89%, respectively. Overall, 36 patients (23%) with acute scrotal pain (50% of patients in the group with confirmed testicular torsion at exploration) required orchidectomy. CONCLUSION: This study supports the practice of immediate surgical exploration with a clinical suspicion of testicular torsion in a paediatric population. SN - 2168-1813 UR - https://www.unboundmedicine.com/medline/citation/23281617/Scrotal_exploration_for_acute_scrotal_pain:_a_10_year_experience_in_two_tertiary_referral_paediatric_units_ L2 - https://www.tandfonline.com/doi/full/10.3109/00365599.2012.752403 DB - PRIME DP - Unbound Medicine ER -