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S18-5
(PP)
INTERMITTENT TESTICULAR PAIN: SURGICAL FINDINGS AND FOLLOW-UP
Haris AHMED, Casey SEIDEMAN, Lane PALMER, Edward REDA and Jordan GITLIN
Hofstra North Shore LIJ Health System, Division of Pediatric Urology, Cohen Children's Medical Center, Lake Success,
USA
PURPOSE
To determine the natural history of children undergoing surgical exploration for intermittent testicular pain.
MATERIAL AND METHODS
We retrospectively reviewed 41 consecutive patients who underwent scrotal exploration and orchidopexy for intermittent
testicular pain. Patients who were taken to the operating room for acute torsion were excluded. Physical exam findings
and radiology results were included for analysis. Intraoperative surgical findings were recorded. Resolution of pain on
postoperative follow-up was our primary endpoint.
RESULTS
39 patients with follow-up were included for analysis. Mean age was 15.2 years (range: 10.6 - 20.8 years). Of the 39
patients, 2 had intraoperative findings of true testicular torsion. Surgical findings for the remaining patients included 12
(31%) with bell clapper deformity, 5 with hydrocele, 1 with torsion of the appendix testicle/epididymis, and 8 with
nonspecific findings. Twelve of 39 patients (31%) had no resolution of pain on follow-up. Of these 12, 1 had an
intraoperative finding of true testicular torsion. The remaining 27 (69.2%) had complete resolution of pain on follow-
up.
CONCLUSIONS
Almost one third of patients explored were noted to have a bell clapper deformity, perhaps indicative of true intermittent
torsion. Only 5% of children who underwent orchidopexy had true testicular torsion at the time of surgery. The
remainder of patients had no discernible surgical indication at the time of surgery other than their recurrent intermittent
pain. The majority of patients were found to have resolution of pain on postoperative follow-up. This was especially
true for patients with bell clapper deformity.