Ultrasound heterogeneity as an indicator of testicular salvage in testicular torsion: A single center experience

Objective: Testicular torsion is a common urological emergency, mainly in the younger population. Our aim is to evaluate the efficacy and value of testicular echogenicity in predicting testicular viability. Methods: Patients who were older than 13 years of age and were discharged with the diagnosis...

Full description

Bibliographic Details
Main Authors: Omran Hasan, Mohamed Mubarak, S. Mohamed Jawad Alwedaie, Hasan Baksh, Husain Alaradi, Ameer Alarayedh, Ali Alaradi, Abdolsalam Ahmadi, Akbar Jalal
Format: Article
Language:English
Published: Elsevier 2022-01-01
Series:Asian Journal of Urology
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2214388221000436
_version_ 1819290807773954048
author Omran Hasan
Mohamed Mubarak
S. Mohamed Jawad Alwedaie
Hasan Baksh
Husain Alaradi
Ameer Alarayedh
Ali Alaradi
Abdolsalam Ahmadi
Akbar Jalal
author_facet Omran Hasan
Mohamed Mubarak
S. Mohamed Jawad Alwedaie
Hasan Baksh
Husain Alaradi
Ameer Alarayedh
Ali Alaradi
Abdolsalam Ahmadi
Akbar Jalal
author_sort Omran Hasan
collection DOAJ
description Objective: Testicular torsion is a common urological emergency, mainly in the younger population. Our aim is to evaluate the efficacy and value of testicular echogenicity in predicting testicular viability. Methods: Patients who were older than 13 years of age and were discharged with the diagnosis of testicular torsion were reviewed. Data obtained included demographic data, history, physical examination results, ultrasound findings including size, color Doppler flow, and echotexture, torsion degrees, and surgical procedure. In addition, the histopathological findings of patients who underwent orchiectomy were reviewed. Results: A total of 71 cases were diagnosed with testicular torsion between January 2016 to December 2018. The mean age at presentation was 20.4±7.0 years. The average time from the onset of pain until the presentation was 36.0±55.1 h. Out of the 71 ultrasound scans reviewed, 45.1% showed homogenous echotexture and 54.9% showed heterogeneous echotexture of the affected testis. On scrotal exploration, the mean degree of torsion was 475.7±301.8 degrees; 66.2% of the patients had a viable testis; and bilateral orchidopexy was done. The remaining 33.8% had a non-viable testis. Homogenous echotexture was after an average of 13.5 h of scrotal pain, while heterogeneous echotexture presented after 53.7 h of scrotal pain. There was a statistically significant difference between the time of presentation and echotexture changes on scrotal ultrasonography (p<0.01). The relationship between echotexture changes and testicular viability was statistically significant as well (p<0.001). Conclusion: A long time since the onset of pain coupled with heterogeneous changes in testicular parenchyma is a good indicator of non-viability. However, we still advocate for surgical exploration as the gold standard in diagnosis and management.
first_indexed 2024-12-24T03:28:37Z
format Article
id doaj.art-74a1c2d505d44d87bd246cac0329569c
institution Directory Open Access Journal
issn 2214-3882
language English
last_indexed 2024-12-24T03:28:37Z
publishDate 2022-01-01
publisher Elsevier
record_format Article
series Asian Journal of Urology
spelling doaj.art-74a1c2d505d44d87bd246cac0329569c2022-12-21T17:17:17ZengElsevierAsian Journal of Urology2214-38822022-01-01915762Ultrasound heterogeneity as an indicator of testicular salvage in testicular torsion: A single center experienceOmran Hasan0Mohamed Mubarak1S. Mohamed Jawad Alwedaie2Hasan Baksh3Husain Alaradi4Ameer Alarayedh5Ali Alaradi6Abdolsalam Ahmadi7Akbar Jalal8Department of Surgery, Salmaniya Medical Complex Ringgold Standard Institution, Manama, BahrainCorresponding author.; Department of Surgery, Salmaniya Medical Complex Ringgold Standard Institution, Manama, BahrainDepartment of Surgery, Salmaniya Medical Complex Ringgold Standard Institution, Manama, BahrainDepartment of Surgery, Salmaniya Medical Complex Ringgold Standard Institution, Manama, BahrainDepartment of Surgery, Salmaniya Medical Complex Ringgold Standard Institution, Manama, BahrainDepartment of Surgery, Salmaniya Medical Complex Ringgold Standard Institution, Manama, BahrainDepartment of Surgery, Salmaniya Medical Complex Ringgold Standard Institution, Manama, BahrainDepartment of Surgery, Salmaniya Medical Complex Ringgold Standard Institution, Manama, BahrainDepartment of Surgery, Salmaniya Medical Complex Ringgold Standard Institution, Manama, BahrainObjective: Testicular torsion is a common urological emergency, mainly in the younger population. Our aim is to evaluate the efficacy and value of testicular echogenicity in predicting testicular viability. Methods: Patients who were older than 13 years of age and were discharged with the diagnosis of testicular torsion were reviewed. Data obtained included demographic data, history, physical examination results, ultrasound findings including size, color Doppler flow, and echotexture, torsion degrees, and surgical procedure. In addition, the histopathological findings of patients who underwent orchiectomy were reviewed. Results: A total of 71 cases were diagnosed with testicular torsion between January 2016 to December 2018. The mean age at presentation was 20.4±7.0 years. The average time from the onset of pain until the presentation was 36.0±55.1 h. Out of the 71 ultrasound scans reviewed, 45.1% showed homogenous echotexture and 54.9% showed heterogeneous echotexture of the affected testis. On scrotal exploration, the mean degree of torsion was 475.7±301.8 degrees; 66.2% of the patients had a viable testis; and bilateral orchidopexy was done. The remaining 33.8% had a non-viable testis. Homogenous echotexture was after an average of 13.5 h of scrotal pain, while heterogeneous echotexture presented after 53.7 h of scrotal pain. There was a statistically significant difference between the time of presentation and echotexture changes on scrotal ultrasonography (p<0.01). The relationship between echotexture changes and testicular viability was statistically significant as well (p<0.001). Conclusion: A long time since the onset of pain coupled with heterogeneous changes in testicular parenchyma is a good indicator of non-viability. However, we still advocate for surgical exploration as the gold standard in diagnosis and management.http://www.sciencedirect.com/science/article/pii/S2214388221000436TestisTesticular torsionOrchiopexyOrchiectomyUltrasoundEchotexture
spellingShingle Omran Hasan
Mohamed Mubarak
S. Mohamed Jawad Alwedaie
Hasan Baksh
Husain Alaradi
Ameer Alarayedh
Ali Alaradi
Abdolsalam Ahmadi
Akbar Jalal
Ultrasound heterogeneity as an indicator of testicular salvage in testicular torsion: A single center experience
Asian Journal of Urology
Testis
Testicular torsion
Orchiopexy
Orchiectomy
Ultrasound
Echotexture
title Ultrasound heterogeneity as an indicator of testicular salvage in testicular torsion: A single center experience
title_full Ultrasound heterogeneity as an indicator of testicular salvage in testicular torsion: A single center experience
title_fullStr Ultrasound heterogeneity as an indicator of testicular salvage in testicular torsion: A single center experience
title_full_unstemmed Ultrasound heterogeneity as an indicator of testicular salvage in testicular torsion: A single center experience
title_short Ultrasound heterogeneity as an indicator of testicular salvage in testicular torsion: A single center experience
title_sort ultrasound heterogeneity as an indicator of testicular salvage in testicular torsion a single center experience
topic Testis
Testicular torsion
Orchiopexy
Orchiectomy
Ultrasound
Echotexture
url http://www.sciencedirect.com/science/article/pii/S2214388221000436
work_keys_str_mv AT omranhasan ultrasoundheterogeneityasanindicatoroftesticularsalvageintesticulartorsionasinglecenterexperience
AT mohamedmubarak ultrasoundheterogeneityasanindicatoroftesticularsalvageintesticulartorsionasinglecenterexperience
AT smohamedjawadalwedaie ultrasoundheterogeneityasanindicatoroftesticularsalvageintesticulartorsionasinglecenterexperience
AT hasanbaksh ultrasoundheterogeneityasanindicatoroftesticularsalvageintesticulartorsionasinglecenterexperience
AT husainalaradi ultrasoundheterogeneityasanindicatoroftesticularsalvageintesticulartorsionasinglecenterexperience
AT ameeralarayedh ultrasoundheterogeneityasanindicatoroftesticularsalvageintesticulartorsionasinglecenterexperience
AT alialaradi ultrasoundheterogeneityasanindicatoroftesticularsalvageintesticulartorsionasinglecenterexperience
AT abdolsalamahmadi ultrasoundheterogeneityasanindicatoroftesticularsalvageintesticulartorsionasinglecenterexperience
AT akbarjalal ultrasoundheterogeneityasanindicatoroftesticularsalvageintesticulartorsionasinglecenterexperience