Nandwani Ghulam Mustafa, Anwar Adeel, Singh Rajindra, Stewart Alistair B, Forster James A, Addla Sanjai K
Department of Urology, Ninewells Hospital and Medical School, Dundee, UK.
Department of Urology, Bradford Teaching Hospital, Bradford, UK.
J Coll Physicians Surg Pak. 2020 Feb;30(2):201-204. doi: 10.29271/jcpsp.2020.02.201.
To study the effects of age and duration of symptoms on the outcomes of scrotal explorations for acute scrotal pain at our institution.
Case series.
Bradford Teaching Hospital NHS Trust, from January 2006 to December 2017.
Retrospective data was collected from electronic case records of the patients who required scrotal exploration for suspected torsion of the testis. Group difference between continuous variables (age and duration of symptoms) were assessed by Kruskal Wallis and independent samples Mann-Whitney U-tests. The Fisher Exact and Chisquare tests were used to analyse relationships between categorical data.
In total, 502 patients required scrotal exploration. The median age (years) and duration of symptoms (hours) were 16.4 years (1.3 - 77) and 4 hours (1 - 336), respectively. Torsion of the testis was found in 231 (46%), torsion of the testicular appendix in 126 (25%), epididymal inflammation in 46 (9.2%), and no cause identified in 99 (19.7%). Immediate orchidectomy for non-viable testis performed in 34 (14.7% of TT group and 6.8% of the overall cohort). Duration of symptoms was significantly associated with risk of orchidectomy in torsion patients 4 vs. 27 hours (p <0.0001). Overall 47 (9.3%) patients presented after 12 hours, 22 (46.8%) had TT. There were 13 (2.6%) patients older than 40 years and 8 (61.5%) of these had torsion.
The most commonest diagnosis for patients presenting with acute scrotal pain was torsion of the testis followed by torsion of appendix testis. Testicular salvage was inversely related to the duration of symptoms. Patient's age did not predict the need for orchidectomy. This data supports the practice of urgent scrotal exploration for acute scrotal pain with a clinical suspicion of torsion regardless of age and duration of symptoms.
研究年龄和症状持续时间对我院急性阴囊疼痛患者阴囊探查结果的影响。
病例系列研究。
2006年1月至2017年12月在布拉德福德教学医院国民保健服务信托基金。
从因疑似睾丸扭转而需要进行阴囊探查的患者的电子病例记录中收集回顾性数据。连续变量（年龄和症状持续时间）之间的组间差异通过Kruskal Wallis检验和独立样本Mann-Whitney U检验进行评估。Fisher精确检验和卡方检验用于分析分类数据之间的关系。
共有502例患者需要进行阴囊探查。年龄中位数（岁）和症状持续时间（小时）分别为16.4岁（1.3 - 77岁）和4小时（1 - 336小时）。发现睾丸扭转231例（46%），睾丸附件扭转126例（25%），附睾炎症46例（9.2%），99例（19.7%）未发现病因。34例（睾丸扭转组的14.7%和整个队列的6.8%）因睾丸无活力而立即进行了睾丸切除术。症状持续时间与睾丸扭转患者行睾丸切除术的风险显著相关，4小时与27小时相比（p <0.0001）。总体而言，47例（9.3%）患者在12小时后就诊，22例（46.8%）患有睾丸扭转。13例（2.6%）患者年龄超过40岁，其中8例（61.5%）患有睾丸扭转。
急性阴囊疼痛患者最常见的诊断是睾丸扭转，其次是睾丸附件扭转。睾丸挽救与症状持续时间呈负相关。患者年龄不能预测是否需要进行睾丸切除术。这些数据支持对临床怀疑睾丸扭转的急性阴囊疼痛患者进行紧急阴囊探查的做法，无论其年龄和症状持续时间如何。
