Impact of Distance From the Hospital and Patient Transfer on Pediatric Testicular Torsion Outcomes

Background: Testicular torsion is the most common pediatric emergency that requires prompt diagnosis and surgical treatment to prevent testicular loss. Distance from the hospital where the patient will be undergoing treatment for testicular torsion and transfer from an outside facility are factors t...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2022-05, Vol.14 (5), p.e25284-e25284
Main Authors: Shields, Lisa B, Daniels, Michael W, Peppas, Dennis S, Rosenberg, Eran
Format: Article
Language:English
Subjects:
Age
Emergency Medicine
Pain
Patients
Pediatric Surgery
Pediatrics
Surgery
Urology
Variables
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Summary:Background: Testicular torsion is the most common pediatric emergency that requires prompt diagnosis and surgical treatment to prevent testicular loss. Distance from the hospital where the patient will be undergoing treatment for testicular torsion and transfer from an outside facility are factors that may impact whether a testis is salvageable. We sought to determine whether these factors play a role in pediatric testicular torsion outcomes. Materials and Methods: We identified males aged 1-18 years with testicular torsion between January 1, 2015 and December 31, 2020. The patients’ distance from our hospital and whether they were transferred from an outlying hospital were a particular focus. Results: The number of miles from our hospital and transfer from an outlying hospital were not significantly different between boys who underwent an orchiectomy versus an orchiopexy (p=0.258 and p=0.574, respectively). The number of miles from our hospital was negatively correlated to age at surgery (rho=-0.22, p=0.01). Significantly (p22.1 miles) from our hospital (32/69 (46%)) versus near our hospital (10/68 (15%)). For every mile boys lived from our hospital, there was no difference (adjusted odds ratio (OR)=0.98 (0.96, 1.00), p=0.10) in the likelihood of receiving an orchiectomy versus an orchiopexy when adjusting for age, symptom duration, and degrees of torsion.Conclusions: Our study determined that neither distance from our hospital nor transfer from an outlying hospital affected the orchiectomy rate. An expedited medical evaluation and surgery offer the best prognosis for salvaging the testes.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.25284