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Title: The amount of spermatic cord rotation magnifies the time-related orchidectomy risk in Intravaginal testicular torsion
Authors: Dias Filho, Aderivaldo Cabral
Alves, João Ricardo
Buson Filho, Hélio
Oliveira, Paulo Gonçalves de
Assunto:: Testículos
Isquemia
Issue Date: Nov-2016
Publisher: Sociedade Brasileira de Urologia
Citation: DIAS FILHO, Aderivaldo Cabral et al. The amount of spermatic cord rotation magnifies the time-related orchidectomy risk in Intravaginal testicular torsion. International braz j urol, Rio de Janeiro, v. 42, n. 6, p. 1210-1219, nov./dez. 2016. Disponível em: <http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382016000601210&lng=en&nrm=iso>. Acesso em: 19 dez. 2017. doi: http://dx.doi.org/10.1590/s1677-5538.ibju.2016.0166.
Abstract: Purpose: to investigate the roles of age, testicular rotation and time in the surgical outcome of intravaginal testicular torsion (iTT). Patients and Methods We retrieved the records of all iTT patients treated in our unit from January 2012 to January 2014. Explanatory variables were: age (years); presentation delay (PrD, time between symptoms and hospitalization); surgical delay (SurgD, time between hospitalization and surgery) and testicular rotation (rotation), with surgical outcome (orchidopexy, orchidectomy) as response variable. Differences in PrD, SurgD, age and rotation by surgical outcome were evaluated non-parametrically. Step-down logistic regression included age, PrD, SurgD and rotation as predictors. Statistical significance and confidence intervals (CI) were set at p<0.05 and 0.95. Odds ratios (OR) were computed from the model's coefficients. Results Complete variable information was available for 117 patients, and most (61, 52.1%) underwent orchidectomy. Ages were similar between orchidectomy and orchidopexy patients (median 15.8 vs. 16.0 years, p=0.78). In contrast, PrD (85.0 vs. 8.4 hours, p<0.001), SurgD (3.0 vs. 16.0 hours, p<0.001) were different between orchidectomy and orchidopexy patients. SurgD was similar with PrD<24 hours (4.0 vs. 2.8, p=0.1). Orchidectomy patients had greater rotation (3.0π vs. 2.0π radians, p<0.001). Logistic regression revealed that PrD (OR 0.94; 0.92–0.97; p<0.001) and rotation (OR 0.43; 0.27–0.70; p<0.001) were inversely associated with orchidopexy. Conclusion Testicular rotation exerts a multiplicative effect on PrD, so time should not be regarded as the sole predictor of surgical outcome in iTT.
Licença:: International braz j urol - This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0). Fonte: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382016000601210&lng=en&nrm=iso. Acesso em: 19 dez. 2017.
DOI: http://dx.doi.org/10.1590/s1677-5538.ibju.2016.0166
Appears in Collections:FMD - Artigos publicados em periódicos

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