Skip to main content Accessibility help
×
Home

LO014: What ultrasonography characteristics predict surgical intervention for testicular torsion in adults?

  • B.W. Ritcey (a1), M. Woo (a1), M.D. McInnes (a1), J. Watterson (a1) and J.J. Perry (a1)...

Abstract

Introduction: Testicular torsion is a time sensitive condition for which there can be significant delays to surgery or transfer to definitive care while trying to obtain an ultrasound to confirm the diagnosis. This study determines the test characteristics for each individual sonographic sign of testicular torsion associated with the patient requiring surgical intervention. Methods: A retrospective health records review of adult patients with acute, non-traumatic scrotal pain or swelling (defined as under 24 hours since onset) presenting to one of two Canadian academic tertiary care emergency departments between November 2009 and March 2013 was performed. A single data abstractor completed a case report form for each patient including demographics, individual ultrasound findings, final diagnosis, and need for surgical intervention. The sensitivity and specificity of each ultrasonographic sign (including testicular heterogeneity, decreased colour doppler, and decreased pulsed wave doppler) at predicting surgical intervention during the same hospital visit was calculated along with 95% confidence intervals. Results: During the study period there were a total of 876 emergency department visits for scrotal pain, of which 198 patients met our inclusion criteria. The included patients had a mean age of 36.2 years. Decreased blood flow to the painful testicle on colour doppler showed the best overall test characteristics with a sensitivity of 82.4% (95% CI 55.8%-95.3%) and specificity of 100% (95% CI 96.3%-100%) for predicting a need for surgical intervention for testicular torsion. Other ultrasound findings for testicular torsion included a heterogeneous appearance of the painful testicle (sensitivity 47.1% [95% CI 23.9%-71.5%], specificity 77.4% [95% CI 68.9%-84.2%]), and decreased arterial or venous flow on pulsed wave doppler (sensitivity 76.5% [95% CI 49.8%-92.1%], specificity 100% [95% CI 96.3%-100%]). Conclusion: Decreased blood flow to the painful testicle on colour doppler showed excellent specificity and can rapidly “rule-in” a need for surgical intervention for testicular torsion. Given that colour doppler is relatively easy to learn and perform, future studies should assess the use of colour doppler using point of care ultrasound to expedite surgical consultation.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      LO014: What ultrasonography characteristics predict surgical intervention for testicular torsion in adults?
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      LO014: What ultrasonography characteristics predict surgical intervention for testicular torsion in adults?
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      LO014: What ultrasonography characteristics predict surgical intervention for testicular torsion in adults?
      Available formats
      ×

Copyright

Keywords

LO014: What ultrasonography characteristics predict surgical intervention for testicular torsion in adults?

  • B.W. Ritcey (a1), M. Woo (a1), M.D. McInnes (a1), J. Watterson (a1) and J.J. Perry (a1)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.