Shields Lisa B E, Daniels Michael W, Peppas Dennis S, Rosenberg Eran
Norton Healthcare, Louisville, KY, USA.
University of Louisville, Louisville, KY, USA.
Glob Pediatr Health. 2021 Nov 23;8:2333794X211059119. doi: 10.1177/2333794X211059119. eCollection 2021.
Patients with intellectual/developmental disabilities are at risk of delayed diagnosis of testicular torsion due to their inability to effectively communicate their symptoms. We identified males ages 1 to 18 years with testicular torsion between January 1, 2015 and December 31, 2020, focusing on patients with intellectual and/or developmental disabilities. Of the 140 patients with testicular torsion, 5 (3.6%) patients exhibited intellectual/developmental disabilities with an inability to effectively verbalize testicular/groin/scrotal pain. The patients with intellectual/developmental disabilities underwent more orchiectomies (5/5, 100%, = .009) and had a longer duration of symptoms (median = 48 hours, = .047) compared to those without intellectual/developmental disabilities (51/135, 38% and median = 9 hours, respectively) (51/134, 38%) ( = .038). Parents and other caregivers of males with intellectual/developmental disabilities who are unable to adequately verbalize their testicular/groin/scrotal pain should be cognizant of the signs and symptoms associated with testicular torsion, perform a genitalia examination, and seek an immediate evaluation to diagnose and treat this urgent condition.
智力/发育障碍患者由于无法有效表达症状,存在睾丸扭转延迟诊断的风险。我们确定了2015年1月1日至2020年12月31日期间年龄在1至18岁之间患有睾丸扭转的男性患者,重点关注智力和/或发育障碍患者。在140例睾丸扭转患者中,5例(3.6%)表现出智力/发育障碍,无法有效表达睾丸/腹股沟/阴囊疼痛。与无智力/发育障碍的患者相比(分别为51/135,38%和中位数为9小时)(51/134,38%),智力/发育障碍患者接受睾丸切除术的比例更高(5/5,100%,P = 0.009),症状持续时间更长(中位数 = 48小时,P = 0.047)(P = 0.038)。无法充分表达睾丸/腹股沟/阴囊疼痛的智力/发育障碍男性的父母和其他照顾者应了解与睾丸扭转相关的体征和症状,进行生殖器检查,并寻求立即评估以诊断和治疗这种紧急情况。