The impact of ultrasound on testicular loss in cases of testicular torsion in children

Pediatr Surg Int. 2024 Mar 20;40(1):83. doi: 10.1007/s00383-024-05663-7.

Abstract

Purpose: Ultrasound as a diagnostic tool in suspicion of testicular torsion is still highly debated. In this investigation, we aimed to evaluate whether time spent on scrotal ultrasonography had a negative impact on testicular loss.

Methods: Patients' records containing a scrotal ultrasound and/or surgical procedure codes for testicular interventions on suspicion of testicular torsion were examined. Patients aged 0-15 years admitted during 2015-2019 at Copenhagen University Hospital, Rigshospitalet were included.

Results: In total, 1566 patients underwent an ultrasound and 142 of these proceeded to surgery while 13 patients proceeded directly to surgery without an ultrasound. The rate of testicular loss with a preceding ultrasound was 23% versus 42% without (p = 0.18). Four cases of testicular torsion were misdiagnosed by ultrasound resulting in a sensitivity of 95.4% and specificity of 95.6%. The mean diagnostic delay from ultrasound examination was 55 ± 39 min, and the mean time from ultrasound to surgery was at 169 ± 76 min versus 171 ± 72 min without ultrasound.

Conclusion: In a clinical setting, ultrasound provided a reliable tool for the diagnosis of testicular torsion and did not seem to increase the orchiectomy rate.

Keywords: Pediatric surgery; Testicular loss; Testicular torsion; Ultrasound.

MeSH terms

  • Child
  • Delayed Diagnosis
  • Humans
  • Male
  • Retrospective Studies
  • Spermatic Cord Torsion* / diagnostic imaging
  • Spermatic Cord Torsion* / surgery
  • Testis / diagnostic imaging
  • Testis / surgery
  • Ultrasonography