Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

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14:56 - 14:59
S17-7 (PP)
PROSPECTIVE EVALUATION OF ASSUMED PREDICTORS OF ATROPHY AFTER
TESTIS TORSION
Gwen GRIMSBY 1, Lauren OSTROV 2, Kunj SHETH3, Micah JACOBS1, Bruce SCHLOMER1, Halim HENNES4 and Linda BAKER1
1) University of Texas Southwestern Medical Center, Pediatric Urology, Dallas, USA - 2) Children's Medical Center,
Dallas, USA - 3) University of Texas Southwestern Medical Center, Urology, Dallas, USA - 4) Children's Medical Center,
Emergency Medicine, Dallas, USA
PURPOSE
Assumed predictors for testis atrophy after acute torsion include intra-operative testis color, pain duration, and red
scrotal skin. We prospectively correlated these factors to testis atrophy.
MATERIAL AND METHODS
Children 2 months-18 years with acute scrotum were enrolled in a NIH study of trans-scrotal near infrared spectroscopy
as a diagnostic test for testicular torsion. Per study protocol, no orchiectomies were performed. Intra-operative testis
color 5 minutes after detorsion [photographic scale: 1-pink, 2-mottled pink, 3-light blue, 4-purple, 5-black, 6-
hemorrhagic/necrotic], pain duration, and presence/absence of red scrotal skin were recorded. Percent volume
difference between normal and affected testis on follow-up ultrasound was compared between patients with and without
risk factors.
RESULTS
Excluding 18 patients lost to follow up, 28 patients underwent ultrasound at mean 115 days (41-319) post-operatively.
Patients who had ≥80% torsed testicle volume loss included 100%(5/5) who had a 5 minute black/hemorrhagic color,
90%(9/10) with pain duration over 12 hours, and 60%(6/10) with preoperative red scrotal skin. Overall, there was no
significant difference in testicular volume loss between patients with and without red scrotal skin, Table 1.
Table 1
Mean volume difference from normal testis (Range) P-value
Color scale
1-4 (n=23) -36% (-100% to 25%)
0.005
5-6 (n=5) -84% (-90% to -80%)
Pain duration (hrs)
0-6 (n=10) -15% (-44% to 25%)
<0.001 6-12 (n=7) -34% (-80% to 12%)
>12 (n=10) -79% (-100% to -7%)
Red skin
Yes (n=10) -54% (-92% to 25%)
0.2
No (n=14) -33% (-90% to 12%)
CONCLUSIONS
Black/hemorrhagic testis 5 minutes after detorsion and pain greater than 12 hours were associated with testis
atrophy. Red scrotal skin was not a reliable predictor of future atrophy and is not a reason to delay exploration.