Time delays in presentation and treatment of acute scrotal pain in a provincial hospital.

Abstract

Acute scrotal pain is a urological emergency due to the possibility of testicular torsion and subsequent testicular loss if correction is not carried out in a timely manner. We conducted a retrospective review of all patients who underwent surgical exploration for acute scrotal pain in a provincial hospital in New Zealand between 1 January 2001 and 31 December 2010. A total of 91 cases were identified. The median delay pre-hospital was 9 h and in-hospital was 2.5 h. Patients who had a non-viable testicular torsion and patients under the age of 14 had longer pre-hospital delays of 24 and 72 h, respectively. In-hospital delays were similar between all pathologies except for non-viable testicular torsions with 7 h and 45 min. Viable testicular torsions had a median in-hospital delay of 2 h and 13 min. Delay from the time of testicular pain until surgical exploration is important for the chances of testicular salvage and is made up mostly of pre-hospital delays. Patients under the age of 14 had longer delays pre-hospital.