1
|
Ali Benali N, Pradère B, Lannes F, Thi Dang V, Mauger de Varennes A, Gaillard C, Berchiche W, Margue G, Bardet F, Manuguerra A, Pinar U, Duquesne I, Plassais C, Wandoren W, Hulin M, Khene ZE, Vallée M, Michiels C, Chabenes M, Gaillard V, Felber M, Kaulanjan K, Dominique I, Sbizerra M, Seizilles de Mazancourt E, Freton L, Gondran-Tellier B, Matillon X. TORSAFUF - Surgical exploration for torsion of spermatic cord suspicion and risk factors for unnecessary surgery: Results of a French nationwide retrospective study on 2940 patients. Prog Urol 2021; 32:92-100. [PMID: 34920923 DOI: 10.1016/j.purol.2021.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/10/2021] [Accepted: 10/31/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUNDS Spermatic cord torsion is a frequent urological emergency that mostly concerns teenagers and young adults. This study aimed to determine the clinical and surgical characteristics of young adults who had scrotal exploration for suspected spermatic cord torsion and to identify clinical risk factors associated with needless scrotal exploration. METHODS We retrospectively collected national data from patients aged 12years and older who underwent a surgical exploration for suspicion of torsion of the spermatic cord between 2005 and 2019 in 17 hospitals. We analyzed demographics, surgical and postoperative characteristics in our population. We compared the cohort according to the intraoperative diagnosis of torsion or not. RESULTS In total, 2940 had surgical exploration: 1802 (61.3%) patients had torsion of the spermatic cord and 1138 (38.7%) had another diagnosis. In multivariate analysis, age (OR: 1.04; 95% CI: 1.01-1.06; P=0.005), medical history of cryptorchism (OR: 4.14; 95% CI: 1.05-16.31; P=0.042) and VAS pain score (OR: 0.91; 95% CI: 0.83-0.98; P=0.018) were risk factors significantly associated with unnecessary surgical exploration. The rate of complications in the 90days after surgery was 11% in the "torsion" group, and 9.7% in the "non-torsion" group (P=0.28). CONCLUSION Scrotal exploration without intraoperative diagnosis of torsion was performed in 40% of our cohort. VAS pain score and cryptorchism history can help for the diagnosis but scrotal exploration remains the way to diagnose spermatic cord torsion and should be performed on the slightest suspicion, even after 24hours of symptoms, as the chances for testicular salvage remains around 50%.
Collapse
Affiliation(s)
- N Ali Benali
- Department of Urology, Poitiers University Hospital, Poitiers, France.
| | - B Pradère
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - F Lannes
- Department of Urology, Nord University Hospital, Marseille, France
| | - V Thi Dang
- Department of Urology, Toulouse University Hospital, Toulouse, France
| | | | - C Gaillard
- Department of Urology, Tours University Hospital, Tours, France
| | - W Berchiche
- Department of Urology, Nord University Hospital, Marseille, France
| | - G Margue
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - F Bardet
- Department of Urology, Dijon University Hospital, Dijon, France
| | - A Manuguerra
- Department of Urology, Nancy University Hospital, Nancy, France
| | - U Pinar
- Department of Urology, Hôpitaux Universitaire Pitié-Salpêtrière, AP-HP, Paris, France
| | - I Duquesne
- Department of Urology, Hôpitaux Universitaire Pitié-Salpêtrière, AP-HP, Paris, France
| | - C Plassais
- Department of Urology, Hôpitaux Universitaire Pitié-Salpêtrière, AP-HP, Paris, France
| | - W Wandoren
- Department of Urology, Pointe-à-Pitre University Hospital, Pointe-à-Pitre, Guadeloupe
| | - M Hulin
- Department of Urology, Reims University Hospital, Reims, France
| | - Z-E Khene
- Department of Urology, Rennes University Hospital, Rennes, France
| | - M Vallée
- Department of Urology, Poitiers University Hospital, Poitiers, France; Poitiers University, INSERM U1070, "Pharmacologie des Anti-Infectieux", UFR Médecine-Pharmacie, Pôle Biologie Santé, Poitiers, France
| | | | - C Michiels
- Department of Urology, Bordeaux University Hospital, Bordeaux, France
| | - M Chabenes
- Department of Urology, Grenoble University Hospital, Grenoble, France
| | - V Gaillard
- Department of Urology, Strasbourg University Hospital, Strasbourg, France
| | - M Felber
- Department of Urology, Nancy University Hospital, Nancy, France
| | - K Kaulanjan
- Department of Urology, Pointe-à-Pitre University Hospital, Pointe-à-Pitre, Guadeloupe
| | - I Dominique
- Department of Urology, Lyon Sud University Hospital, Lyon, France
| | - M Sbizerra
- Department of Urology, Lyon Sud University Hospital, Lyon, France
| | | | - L Freton
- Department of Urology, Rennes University Hospital, Rennes, France
| | | | - X Matillon
- Department of Urology, Lyon Sud University Hospital, Lyon, France
| |
Collapse
|
3
|
Berchiche W, Sbizzera M, Lannes F, Pinar U, Duquesne I, Felber M, Plassais C, Dang V, Ali Benali N, Gaillard C, Mauger De Varennes A, Margue G, Bardet F, Hulin M, Manuguerra A, Wandoren W, Chabennes M, Gaillard V, Matillon X, Khene Z, Pradere B. Impact of testicular torsion on fertility and erectile dysfunction: A multicenter national retrospective studyTORSAFUF. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00899-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
4
|
Seizilles de Mazancourt E, Pradere B, Duquesne I, Pinar U, Felber M, Plassais C, Dang V, Ali Benali N, Berchiche W, Gaillard C, Mauger de Varennes A, Margue G, Bardet F, Hulin M, Manuguerra A, Wandoren W, Chabenes M, Sbizzera M, Khene Z, Matillon X. Heure limite de prise en charge opératoire pour torsion du cordon spermatique : résultats d’une série rétrospective multicentrique de 2986 patients sur 15 ans. Prog Urol 2020. [DOI: 10.1016/j.purol.2020.07.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|