Intermittent Testicular Torsion in Adults: An Overlooked Clinical Condition

• Published in: Medical principles and practice 2017-01, Vol.26 (1), p.30-34
• Main Authors: Al-Kandari, Ahmed M., Kehinde, Elijah O., Khudair, Salah, Ibrahim, Hamdy, ElSheemy, Mohammed S., Shokeir, Ahmed A.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adults; Analgesics - therapeutic use; Follow-Up Studies; Humans; Ischemia; Male; Middle Aged; Orchiopexy; Original Paper; Pain; Pain - drug therapy; Pain - etiology; Pain - surgery; Pain Management - methods; Patients; Spermatic Cord Torsion - complications; Spermatic Cord Torsion - drug therapy; Spermatic Cord Torsion - surgery; Statistical analysis; Ultrasonic imaging; Urology; Visual Analog Scale; Young Adult
• ISSN: 1011-7571; 1423-0151
• DOI: 10.1159/000450887

Objectives: The aim of this study was to describe the management protocol for intermittent testicular torsion (ITT) in adults and report the outcome of this clinical condition, which is commonly overlooked in adults. Subjects and Methods: Sixty-three patients were included in the study. The inclusion criterion was the presence of sudden intermittent testicular pain over a duration of 3 months. All the patients underwent clinical examination, urine analysis, culture, and scrotal ultrasound with Doppler. The testicle was in an abnormal or in transverse lie and/or could easily be twisted. Scrotal support and analgesia were given for 1 month, then patients were offered orchidopexy or conservative treatment. Nineteen patients chose orchidopexy while 44 chose conservative treatment. Follow-up ranged from 3 months to 2 years. The improvement was assessed using a visual analog pain score. The outcome of the treatment was compared between the surgical and conservative groups using a χ 2 test. Results: The median age of the patients was 28 years (range: 17-50). Of the 19 patients who underwent orchidopexy, the pain resolved or visual analog pain scores improved (median 1/10) in 18 (94.7%) cases. On the other hand, 21 of the 44 (47.7%) cases that chose the conservative approach claimed their pain resolved or improved (visual analog pain scores: median 3/10) with a median of 13 months of follow-up. Conclusion: In this study, scrotal orchidopexy proved to be superior to conservative measures in cases of ITT in adults.