Clinical predictors of testicular torsion in children

Michael Boettcher; Robert Bergholz; Thomas F Krebs; Katharina Wenke; Daniel C Aronson

doi:10.1016/j.urology.2011.10.041

Clinical predictors of testicular torsion in children

Standard

Clinical predictors of testicular torsion in children. / Boettcher, Michael; Bergholz, Robert; Krebs, Thomas F; Wenke, Katharina; Aronson, Daniel C.

in: UROLOGY, Jahrgang 79, Nr. 3, 01.03.2012, S. 670-4.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Boettcher, M, Bergholz, R, Krebs, TF, Wenke, K & Aronson, DC 2012, 'Clinical predictors of testicular torsion in children', UROLOGY, Jg. 79, Nr. 3, S. 670-4. https://doi.org/10.1016/j.urology.2011.10.041

APA

Boettcher, M., Bergholz, R., Krebs, T. F., Wenke, K., & Aronson, D. C. (2012). Clinical predictors of testicular torsion in children. UROLOGY, 79(3), 670-4. https://doi.org/10.1016/j.urology.2011.10.041

Vancouver

Boettcher M, Bergholz R, Krebs TF, Wenke K, Aronson DC. Clinical predictors of testicular torsion in children. UROLOGY. 2012 Mär 1;79(3):670-4. https://doi.org/10.1016/j.urology.2011.10.041

Bibtex

@article{e7232515cda64aabaa7330f16f88eebc,

title = "Clinical predictors of testicular torsion in children",

abstract = "OBJECTIVE: To distinguish the prognostic factors that decrease the probability of a negative exploration for {"}acute scrotum.{"} In some institutes, patients with {"}acute scrotum{"} undergo immediate exploration after clinical evaluation. Because testicular torsion (TT) accounts only for a fraction of these cases, most infants can be treated conservatively.METHODS: We performed a retrospective study of all patients treated at our institute from January 2008 to December 2009 for the diagnosis of {"}acute scrotum.{"} Differences between groups were calculated using the chi-square test or analysis of variance and Mann-Whitney-Wilcoxon test for univariate or multivariate analysis, expressed as odds ratios (ORs) and 95% confidence intervals (CIs).RESULTS: The data from 138 patients were analyzed. The mean age was 9 years, 8 months. Of the 138 patients, 19 (13.8%) had TT. This group was compared with the boys without TT at exploration. The patients with TT were older on average (11 years, 1 month vs 9 years, 1 month, p = .035). Pain for <24 hours (OR 4.2, 95% CI 1.3-13.4), nausea and/or vomiting (OR 21.6, 95% CI 4.9-93.4), abnormal cremasteric reflex (OR 4.8 95% CI 0.7-35.2), and a high position of the testis (OR 18.0 95% CI 1.8-177.1) were associated with an increased likelihood of torsion. In the group of boys with ≥ 2 of these findings present, 100% had TT at exploration, with 0% false-positive results.CONCLUSION: TT is uncommon among the group of boys treated for {"}acute scrotum.{"} In particular, a pain duration <24 hours, nausea or vomiting, a high position of the testis, and an abnormal cremasteric reflex had a positive prognostic value for TT. A clinical score might help to avoid unnecessary explorations. In the future, we intend to test the diagnostic set described combined with ultrasonography.",

keywords = "Age Distribution, Chi-Square Distribution, Child, Humans, Male, Retrospective Studies, Scrotum, Spermatic Cord Torsion",

author = "Michael Boettcher and Robert Bergholz and Krebs, {Thomas F} and Katharina Wenke and Aronson, {Daniel C}",

year = "2012",

month = mar,

day = "1",

doi = "10.1016/j.urology.2011.10.041",

language = "English",

volume = "79",

pages = "670--4",

journal = "UROLOGY",

issn = "0090-4295",

publisher = "Elsevier Inc.",

number = "3",

}

RIS

TY - JOUR

T1 - Clinical predictors of testicular torsion in children

AU - Boettcher, Michael

AU - Bergholz, Robert

AU - Krebs, Thomas F

AU - Wenke, Katharina

AU - Aronson, Daniel C

PY - 2012/3/1

Y1 - 2012/3/1

N2 - OBJECTIVE: To distinguish the prognostic factors that decrease the probability of a negative exploration for "acute scrotum." In some institutes, patients with "acute scrotum" undergo immediate exploration after clinical evaluation. Because testicular torsion (TT) accounts only for a fraction of these cases, most infants can be treated conservatively.METHODS: We performed a retrospective study of all patients treated at our institute from January 2008 to December 2009 for the diagnosis of "acute scrotum." Differences between groups were calculated using the chi-square test or analysis of variance and Mann-Whitney-Wilcoxon test for univariate or multivariate analysis, expressed as odds ratios (ORs) and 95% confidence intervals (CIs).RESULTS: The data from 138 patients were analyzed. The mean age was 9 years, 8 months. Of the 138 patients, 19 (13.8%) had TT. This group was compared with the boys without TT at exploration. The patients with TT were older on average (11 years, 1 month vs 9 years, 1 month, p = .035). Pain for <24 hours (OR 4.2, 95% CI 1.3-13.4), nausea and/or vomiting (OR 21.6, 95% CI 4.9-93.4), abnormal cremasteric reflex (OR 4.8 95% CI 0.7-35.2), and a high position of the testis (OR 18.0 95% CI 1.8-177.1) were associated with an increased likelihood of torsion. In the group of boys with ≥ 2 of these findings present, 100% had TT at exploration, with 0% false-positive results.CONCLUSION: TT is uncommon among the group of boys treated for "acute scrotum." In particular, a pain duration <24 hours, nausea or vomiting, a high position of the testis, and an abnormal cremasteric reflex had a positive prognostic value for TT. A clinical score might help to avoid unnecessary explorations. In the future, we intend to test the diagnostic set described combined with ultrasonography.

AB - OBJECTIVE: To distinguish the prognostic factors that decrease the probability of a negative exploration for "acute scrotum." In some institutes, patients with "acute scrotum" undergo immediate exploration after clinical evaluation. Because testicular torsion (TT) accounts only for a fraction of these cases, most infants can be treated conservatively.METHODS: We performed a retrospective study of all patients treated at our institute from January 2008 to December 2009 for the diagnosis of "acute scrotum." Differences between groups were calculated using the chi-square test or analysis of variance and Mann-Whitney-Wilcoxon test for univariate or multivariate analysis, expressed as odds ratios (ORs) and 95% confidence intervals (CIs).RESULTS: The data from 138 patients were analyzed. The mean age was 9 years, 8 months. Of the 138 patients, 19 (13.8%) had TT. This group was compared with the boys without TT at exploration. The patients with TT were older on average (11 years, 1 month vs 9 years, 1 month, p = .035). Pain for <24 hours (OR 4.2, 95% CI 1.3-13.4), nausea and/or vomiting (OR 21.6, 95% CI 4.9-93.4), abnormal cremasteric reflex (OR 4.8 95% CI 0.7-35.2), and a high position of the testis (OR 18.0 95% CI 1.8-177.1) were associated with an increased likelihood of torsion. In the group of boys with ≥ 2 of these findings present, 100% had TT at exploration, with 0% false-positive results.CONCLUSION: TT is uncommon among the group of boys treated for "acute scrotum." In particular, a pain duration <24 hours, nausea or vomiting, a high position of the testis, and an abnormal cremasteric reflex had a positive prognostic value for TT. A clinical score might help to avoid unnecessary explorations. In the future, we intend to test the diagnostic set described combined with ultrasonography.

KW - Age Distribution

KW - Chi-Square Distribution

KW - Child

KW - Humans

KW - Male

KW - Retrospective Studies

KW - Scrotum

KW - Spermatic Cord Torsion

U2 - 10.1016/j.urology.2011.10.041

DO - 10.1016/j.urology.2011.10.041

M3 - SCORING: Journal article

C2 - 22386422

VL - 79

SP - 670

EP - 674

JO - UROLOGY

JF - UROLOGY

SN - 0090-4295

IS - 3

ER -