CORROBORATING TESTICULAR WORK UP FOR ISCHEMIAAND SUSPECTED TORSION [TWIST] SCORE IN THE EVALUATION OF TESTICULAR TORSION IN PATIENTS PRESENTING WITH ACUTE SCROTUM: A STUDY FROM A TERTIARY CARE CENTRE IN CENTRAL INDIA

Abstract

Objective: To study the testicular workup for ischemia and suspected torsion (TWIST) score for evaluation of patients presenting with acute scrotum. Method:An observational study was done amongst the patients presenting with acute scrotum of the emergency department of a tertiary care hospital. The scoring system , as described by Barbosa, et al, consisted of testicular swelling(2), hard testicle(2), absent cremastric reex(1), nausea/vomiting(1), high riding testis(1). Along the entire duration of the study the same standard of resources were used in terms of radiological investigations and the surgery performed. Results: In the testicular torsion group, the mean TWIST score was 5.4 ranging from 4 to 7 while in the non torsion group it was 2.81 ranging from 2 to 6. In the testicular torsion group the no. of patients belonging to low, intermediate and high risk was 0, 2 and 8, respectively, while the number of patients without testicular torsion was 5, 5 and 1 in low, intermediate and high risk groups respectively. Conclusion: The testicular workup for ischemia and suspected torsion (TWIST) score can be used a tool for evaluation of patients presenting with acute scrotum. The score has a high positive predictive value for testicular torsion