A multicentre prospective study evaluating the outcomes from emergency scrotal exploration
BAUS ePoster online library. Morton S. Jun 26, 2018; 211359
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Mr. Simon Morton
Mr. Simon Morton
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Abstract
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Introduction: We wanted to collect contemporary data on the pathway from referral to discharge in a consecutive cohort of patients undergoing emergency scrotal exploration. Secondly we wanted to assess for pre-operative investigations that may correlate with the finding of torsion at operation.

Materials & Methods: Patients with suspected torsion were prospectively identified in different hospitals within a single region in the UK. Patient data was collected from June 2017 to November 2017.

Results: 116 consecutive patients were included in this study, median age 13 (range 0.25-68 yrs). 97% of patients presented with pain, 54% swelling, 34% skin changes, 2.5% lower urinary tract symptoms and 2% with fever. Median transfer time for Urological assessment was 45 (range 0-300 min). Median time to theatre was 90 (range 15-720 min). 42% of patients had a urinalysis prior to theatre. 22% patients had routine bloods. Eight patients had pre-operative ultrasound (US), with 100% correlation to surgical findings. Operative findings were: torsion 20%, torted hydatid 30%, epididymo-orchitis 18%, negative findings 30% and other pathology 2%. 41% of patients had a three point orchidopexy. Four patients underwent orchidectomy. 2.5% had immediate complications. 72% of patients responded to six week follow up which identified 5% wound infection, 6% pain and 7% palpable suture. No re-explorations were performed.

Conclusions: This multicentre study has confirmed a relatively low rate of testicular torsion and short term complications. Interestingly the study highlights the need for a larger scale study to re-evaluate the role of pre-operative US in patients undergoing scrotal exploration.
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