Relationship between testicular torsion and seasonal changes in adolescence

Abstract

Objective To investigate the correlation between testicular torsion in adolescence and seasonal temperature changes. Methods The clinical data of 28 children with testicular torsion diagnosed surgically at Wuhan Children′s Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from June 2009 to December 2017 were retrospectively analyzed.Seasons and temperatures at the onset of the disease in the area were recorded based on hospital information and China Meteorological Science Data Sharing Service Network.According to the seasons of onset, 28 children were divided into spring group, summer group, autumn group and winter group. Results The average age of 28 cases was 13.0 years (10.4-17.0 years). The duration of the disease was 1-4 days [(1.0±0.4) days]. Testicular torsion was found in 17 cases (60.7%) on the right side and 11 cases (39.3%) on the left side.Six patients (21.4%) underwent testicular reduction and bilateral testicular fixation, 22 patients (78.6%) underwent torsional orchiectomy plus contralateral testicular fixation.Testicular torsion was observed in 16 patients (57.1%) during the 3 months from December to February when the median temperature of onset was 1.3 ℃ (-2.1-5.6 ℃). Testicular torsion was observed in 6 patients (21.4%) during the 3 months of spring (March to May) when the median temperature was 9.4 ℃ (6.5-12.1 ℃). During the 3 months of summer (June to August), testicular torsion was observed in 2 patients (7.1%) when the median temperature was 21.8 ℃ (19.0-26.5 ℃). Testicular torsion was observed in 4 patients (14.4%) during the 3 months of autumn (September to November) when the median temperature was 11.1 ℃ (8.0-13.2 ℃). The incidence of testicular torsion in different seasons was significantly different (χ2=3.270, P=0.011). Pearson correlation analysis showed that the incidence of testicular torsion in adolescence was significantly negatively correlated with the season (winter) (r=-1.000, P=0.026). Conclusions Testicular torsion in children tends to be seasonal, and acute testicular torsion is more likely to occur in cold seasons. Key words: Adolescence; Season; Testicular torsion; Hypothermia