Time delays in presentation and treatment of acute scrotal pain in a provincial hospital

ANZ J Surg. 2015 May;85(5):330-3. doi: 10.1111/ans.12601. Epub 2014 May 7.

Abstract

Background: Acute scrotal pain is a urological emergency due to the possibility of testicular torsion and subsequent testicular loss if correction is not carried out in a timely manner.

Methods: We conducted a retrospective review of all patients who underwent surgical exploration for acute scrotal pain in a provincial hospital in New Zealand between 1 January 2001 and 31 December 2010.

Results: A total of 91 cases were identified. The median delay pre-hospital was 9 h and in-hospital was 2.5 h. Patients who had a non-viable testicular torsion and patients under the age of 14 had longer pre-hospital delays of 24 and 72 h, respectively. In-hospital delays were similar between all pathologies except for non-viable testicular torsions with 7 h and 45 min. Viable testicular torsions had a median in-hospital delay of 2 h and 13 min.

Conclusion: Delay from the time of testicular pain until surgical exploration is important for the chances of testicular salvage and is made up mostly of pre-hospital delays. Patients under the age of 14 had longer delays pre-hospital.

Keywords: acute pain; age factors; delayed diagnosis; scrotum; spermatic cord torsion.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Child
  • Child, Preschool
  • Delayed Diagnosis / statistics & numerical data*
  • Emergency Medical Services
  • Hospitals
  • Humans
  • Male
  • Middle Aged
  • New Zealand
  • Pain / etiology*
  • Retrospective Studies
  • Scrotum
  • Spermatic Cord Torsion / complications
  • Spermatic Cord Torsion / diagnosis*
  • Spermatic Cord Torsion / surgery*
  • Time Factors
  • Treatment Outcome
  • Young Adult