Ethnic minorities are at greater risk of presenting late with acute scrotal pain

Abstract

Aim: Delayed presentation in acute testicular torsion increases risk of testicular loss. We investigated whether there is a delay in presentation with suspected torsion in patients from an ethnic minority. Patients and methods: A retrospective audit of patients undergoing scrotal exploration for suspected torsion from September 2014 to September 2019 was completed. Notes were used to identify time between onset of pain and presentation to hospital. Patients’ ethnicity was identified through voluntary demographic information. Median time to presentation was compared between ethnic minorities and white British patients, as well as exploration findings. Results: Ethnic minority patients ( n=29) with suspected torsion presented significantly later with a median of 19 hours (range 1.3–192) compared to 4 hours (0.5–96) in white British patients ( n=65). ( p<0.001) In patients found to have torsion with or without testicular loss, ethnic minority patients ( n=18) presented at a median of 17.5 hours (3.1–192) compared to 3 hours (0.5–84) in white British patients ( n=33), a statistically significant delay ( p<0.001). The relative risk of ethnic minorities requiring orchidectomy when presenting with torsion was 12.83. Conclusion(s): In our population, ethnic minorities present later with acute scrotal pain, increasing their risk of testicular loss. More study is required to identify causes of delayed presentation in these patients with the aim of improving health education. Level of evidence: 3