The Effect of Manual Detorsion on Testicular Salvage Rates in Adult Testicular Torsion Patients: Single Center Experience

Abstract

Aim: The aim of this study was to reveal the effect of manual detorsion on testicular salvage rates and the factors affecting the success of manual detorsion in adult testicular torsion. Material and Methods: The records of patients who applied to the emergency department with pre-diagnosis of acute scrotum were examined. A total of 62 adult patients diagnosed with testicular torsion were included in the study. Manual detorsion was attempted in all patients before surgery. Demographic characteristics of the patients, time from onset of scrotal pain to hospital admission (<24 hours/>24 hours), physical examination and ultrasonography findings, type of surgery performed, and long-term results were evaluated. The data were statistically compared between patients with manual detorsion considered successful and unsuccessful. Results: Manual detorsion was considered successful in 36 (58.1%) patients and unsuccessful in 26 (41.9%) patients. Orchiopexy was performed in 35 (97.2%) of the successful patients and in 11 (42.3%) of the unsuccessful patients (p<0.001). When subgroup analysis was performed, although there was no significant difference in pain duration between patients with and without successful manual detorsion for patients with pain duration of less than 24 hours (p=0.648), there was a statistically significant difference in testicular salvage rates. While the rate of orchiectomy was 1/35 (2.9%) in patients with successful manual detorsion, this rate was 8/19 (42.1%) in unsuccessful patients (p<0.001). Conclusion: Manual detorsion increases testicular salvage rates in adult patients diagnosed with testicular torsion, and it should be attempted especially in patients with pain duration less than 24 hours.