Incidence Of Testicular Torsion Research Articles

Degrees of Testicular Atrophy Following Orchidopexy for Testicular Torsion.

Introduction Testicular torsion is an urological emergency. It is a time-sensitive condition in which twisting of the spermatic cord and testicular blood supply occurs, causing acute onset severe scrotal pain. The incidence of testicular torsion is highest amongst prepubertal males; however, it can occur at any age. Every hour that passes from the onset of symptoms has been shown to decrease the salvageability rate of the torted testis. Another significant factor that impacts testicular salvage is the degree of torsion. Prompt surgical exploration of the scrotum and orchidopexy, if the testis is salvageable, is the mainstay of treatment. A major sequela following orchidopexy for torsion is the decrease in testicular volume. The aim of this study is to assess testicular volume loss post orchidopexy in patients who presented with testicular torsion, as well as to identify the significance of the degree of rotation and duration of torsion in post-fixation volume loss. Methods This is a retrospective study in which all patients who underwent scrotal exploration for a primary diagnosis of testicular torsion between June 1, 2016, to January 15, 2023, were reviewed. The information obtained included the patients' demographics such as age, duration of symptoms, and laterality. Ultrasound images were reviewed for pre- and postoperative findings which included confirmation of testicular torsion as well as testicular volume measurements. Patients were excluded if they underwent an orchidectomy, had a diagnosis other than testicular torsion once scrotal exploration was done, or did not perform a follow-up scrotal ultrasound. Additionally, patients who underwent an orchidopexy for undescended testis earlier in life were also excluded. For statistical analysis purposes, degrees of testicular torsion and time to surgery were classified into mild, moderate, and severe. Results A total of 109 patient records were reviewed within the specific time frame. Of these, 47 patients were excluded as per the exclusion criteria mentioned previously, which gave us a sample size of 62 patients. Our findings showed that increasing severity of the degree of torsion as well as the time for surgery have statistically significant (p-value <0.05) effects on postoperative testicular volume loss. However, it was noted that time to surgery has a more pronounced effect on the mean volume loss than the degree of torsion. Moreover, the analysis also showed that, on average, with every additional hour from the onset of symptoms to surgery, the approximate volume loss is 0.15 ml. However, once time exceeds the 4.5-hour mark, the mean volume loss is 0.4 ml for each additional hour. Conclusion The current study indicates that earlier surgical intervention and correction of torsion are associated with enhanced preservation of postoperative testicular volume. Both the degree of torsion and time to surgery influence mean volume loss; however, time to surgery has a greater impact on the mean volume loss. These results highlight the importance of early diagnosis and intervention in cases of testicular torsion to minimize the risk of long-term testicular volume loss.

The incidence of testicular torsion and testicular salvage rate in Korea over 10 years: A nationwide population-based study.

PurposeWe performed a nationwide epidemiological study of testicular torsion using the National Health Insurance System database for the entire male population of Korea.Materials and MethodsAge, sex, socioeconomic status, regional information, and diagnostic codes were retrieved from January 2009 to December 2019. To clearly identify the diagnosis of testicular torsion, patients who had not undergone orchiectomy or orchiopexy were excluded from the study. Multivariable logistic regression models were used to analyze the association between demographic characteristics and testicular loss.ResultsThe overall incidence of testicular torsion in males was 2.02 cases per 100,000 person-years and 6.99 cases per 100,000 person-years in males under 19 years of age. Testicular torsion most commonly occurred either in infancy or adolescence. The total testicular salvage rate was 75.22% and highest in children at 79.91%. The rate of orchiectomy was high in infancy and in the oldest patients. We determined that age distribution was related to the risk of testicular loss.ConclusionsThis study is the first nationwide epidemiological study of testicular torsion, which contains the entire Korean population. Although the testicular salvage rate in Korea was higher compared to other countries, it is necessary to educate males under 19 years of age on the seriousness of acute testicular pain to minimize the possibility of testicular loss.

Testicular torsion in Ireland: a 10-year analysis of incidence and risk of orchidectomy.

The estimated incidence of testicular torsion (TT) is 4 per 100,000 males under 25years[1]. Age, region and health insurance status have been associated with a higher risk of orchidectomy following TT[2]. This study aimed to establish incidence rates for TT in Ireland for the first time. Sociodemographic characteristics were analysed to assess risk factors for undergoing orchidectomy. A retrospective analysis of a national database, Hospital In-Patient Enquiry (HIPE), was carried out. Cases of TT treated between 2009 and 2018 were identified. Incidence and age-specific rates were calculated in conjunction with census data. Descriptive statistics, non-parametric tests and logistic regression were used to evaluate risk factors for orchidectomy. Between 2009 and 2018, 1746 males under 25years underwent scrotal exploration for TT. The crude incidence was 21.76 per 100,000 population. The age-standardised rate rose from 16.85 per 100,000 in 2009 to 26.31 per 100,000 in 2018. TT was most common in the 10-14years age-group (n = 766, 43%) with a normal distribution across age-groups. TT most commonly occurred in spring (27.55%, 95% CI 25.46-29.71%), and was least common in summer (21.65%, 95% CI 19.46-23.36%, p < 0.01). Age, lack of private insurance, province of residence and transfer from another hospital were associated with orchidectomy. The incidence of TT appears to be higher in Ireland than elsewhere. Epidemiological data for TT in Ireland will help inform health policy and clinical guidelines, facilitate comparison with other jurisdictions and improve public awareness. Further research is needed to identify modifiable risk factors that predict treatment outcomes.

Emergency scrotal exploration in children: Is it time for a change in mindset in the UK?

Acute scrotal pain is a common problem in children. Amongst the various causes, only testicular torsion (TT) needs urgent, and arguably any, surgical intervention. However TT accounts for only approximately 25% of cases. The diagnosis of TT is currently based mainly on history and clinical examination in the UK. We sought to find the incidence of finding TT during emergency scrotal exploration in four paediatric surgical centres in the UK. We also assessed the preoperative utilisation of clinical risk scores and Doppler ultrasound (DUS) to aid in the diagnosis. A retrospective review of 50 consecutive scrotal explorations done for acute scrotal pain at four tertiary pediatric surgical centres in 2019, including the preoperative utilisation of DUS, was analysed. Additionally an online survey was also sent out to consultant members of the British Association of Paediatric Urology to gauge their threshold for exploration, use of preoperative investigations and incidence of finding TT in their practice. In the four UK centres reviewed, TT was found in 24.5% (SD=8.54) of explorations. The overall utilisation of preoperative DUS was 10%. The online survey revealed a low threshold for exploration. However 72% of respondents recalled finding TT in <50% of explorations, with just over a third reporting finding TT in only 10% of explorations. There was low utilisation of preoperative DUS and clinical risk scores. The incidence of finding TT during exploration in this cohort is the same as the incidence of TT in a population of children presenting with acute scrotal pain. We hypothesise that this is due to low accuracy of clinical assessment, low utilisation of preoperative clinical and radiological aids and the practice of exploring torted testicular appendages. Improving awareness and training in these modalities will increase diagnostic accuracy, limiting emergency scrotal explorations to those children with a higher risk of testicular torsion. A care pathway for children presenting with acute scrotal pain is suggested () CONCLUSIONS: There is a low incidence of finding testicular torsion during paediatric scrotal explorations in the UK. There is low preoperative utilisation of clinical risk scores and Doppler ultrasound, which if utilised, could improve diagnostic accuracy.

Relationship between testicular torsion and seasonal changes in adolescence

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

Immediate and delayed effects of atmospheric temperature in the incidence of testicular torsion

Ongoing controversy surrounds the role of atmospheric temperature in the incidence of intravaginal testicular torsion (iTT). This debate may be attributed to inadequate research methodology. As environmental risk factors have been successfully investigated with distributed lag non-linear model regression (DLNM), we applied this methodology to investigate the association between daily mean atmospheric temperatures (Tmean) and daily incidences of intravaginal testicular torsion (iTT) in our region. We analyzed time series consisting of the daily incidences of surgically confirmed iTT according to Tmean, in a circumscribed region in central Brazil from 2012 to 2015, with non-parametric tests, unadjusted and seasonally and long-term trend adjusted time series regression, as well as with DLNM. We recovered 218 cases of iTT in 1125 days of study. Most patients were teenagers (median 15.8 years, interquartile range 14.1-18.5 years). Within the 188 days with events, a single event was recorded on 161 days, two events were recorded on 24 days, and three events were recorded on 3 days. Tmean was lower in days with iTT compared with days without iTT (median 21.4°C vs. 20.9°C, p=0.0002). We found decreasing magnitude and uncertainty of the direction of the effect of Tmean as a risk factor for iTT as the time series regression model was adjusted for seasonal and long-term trends. DLNM indicated a more complex exposure-response relation, with a proportional increase in risk when Tmean fell below 19.4°C at the day of exposure (for 18.0°C, RR 4.35) and a protective effect, for similar temperatures, after 1-2 and 7-12 days of exposure (RR 0.44 and 0.78, respectively). The association between lower Tmean and higher incidences of iTT at first observed with conventional non-parametric tests and unadjusted time series regression disappeared with adjusted time series regression models, reproducing the conflicting results of the literature. In contrast, DLNM revealed both a proportional effect of Tmean with decreasing temperatures and a delayed decrease in risk, suggesting a harvesting effect, seen when the pool of susceptible patients is depleted at exposure leading to a subsequent decrease in the incidence of the disease. According to DLMN, exposures to lower Tmean were associated with immediate greater risk and delayed reduction in risk for iTT. This pattern, indicating a harvesting effect, strongly argues that low temperatures do constitute a risk factor for iTT.

ASSOCIATION BETWEEN THE RISK OF TESTICULAR TORSION AMONG ACUTE SCROTUM AND AMBIENT TEMPERATURE.

(Objectives) Testicular torsion (TT) is a socially and clinically important urological emergency condition because delayed diagnosis and treatment can lead to testicular loss. Although a possible association between TT and low ambient temperature has been argued, the clinical significance of the association has not been fully elucidated. We retrospectively collected acute scrotum cases and investigated the association between the risk of TT among acute scrotums and ambient temperatures on the day of onset. (Patients and methods) We studied 105 consecutive acute scrotum patients with suspected TT who underwent urgent surgical exploration between October 2004 and October 2014. The patients' age, residential area, time and date of onset, laboratory findings, and operative findings were collected from their medical records. Climate data, including daily mean ambient temperature (DMAT), diurnal temperature change (DTC), humidity, and atmospheric pressure at the time of onset, were obtained from the Japan Meteorological Agency website. The chi-square and Wilcoxon rank sum tests were used to evaluate statistical differences. Logistic regression analysis used to identify significant predictors of TT. (Results) The median age of the patients was 13 years (range, 1-43 years). The affected side was the right/left/bilateral side in 46/58/1 of the patients. Surgical exploration revealed TT in 67 patients. The remaining 38 non-TT patients included 12 with testicular appendage torsions, 12 with epididymal appendage torsions, 9 with epididymitis, 2 with orchitis, 2 with idiopathic hematomas, and 1 with allergic purpura. The median DMATs at the day of onset were 10.8°C (1.8-29.4°C) in the TT patients and 19.4°C (1.9-29.1°C) in the non-TT patients. The incidence of TT among the patients with acute scrotum explored surgically (TT incidence) in days with DMATs <15°C (80%) was significantly higher than that in days with DMATs ≥ 15°C (45%; p<0.001). During days with DMATs ≥15°C, the TT incidence in days with DTCs ≥10°C (62%) was significantly higher than that in days with DTCs <10°C (32%; p=0.037). Multivariate analysis revealed higher age (≥14), low serum C-reactive protein level (<0.5 ng/ml) and low DMAT (<15°C) were significant risk factor for TT in patients with acute scrotum undergoing surgery. (Conclusions) It should be noted that in this study, the onset of acute scrotum during days with low ambient temperatures or large DTCs was associated with a moderate to high possibility of TT.

Clinical analysis of 49 cases with testicular torsion

To improve the diagnosis and treatment of testicular torsion. The clinical features of 49 testicular torsion patients admitted to Department of Urology Nanjing Drum Tower Hospital from April 2008 to March 2014 were retrospectively analyzed, the average age was (21 ± 6) years (range 13-52 years).Forty-four cases underwent the color Doppler flow imaging of scrotum, demonstrated reduction of the testicular blood supply in 9 cases and loss of the testicular blood supply in 35 cases. Orchiectomy or orchiopexy was performed according to the testicular blood supply, the contralateral testis fixation was performed in all patients. A two-tailed Student's t-test was used to compare the data between two groups, Pearson correlation analysis was used to analyze the correlation of diurnal temperature and number of cases. All the patients with testicular torsion were Tunica-reversed, 38 (77.5%) cases occurred from November to April. The monthly incidence of testicular torsion was positively correlated with diurnal temperature (r = 0.6434, P = 0.024). Forty-four cases underwent the color Doppler flow imaging, demonstrated the reduction or loss of the testicular blood supply, and these patients were confirmed to be testicular torsion by surgical exploration. The salvage rates of testis in patients with testicular torsion were 2/2, 5/15, 2/9 and 4.2% (1/24) in those seeking medical attention within 6, 12, 24 hours and over 24 hours after the onset of pain. All the patients were followed up for 3 to 75 months, and no one experienced recurrent torsion. The incidence of testicular torsion is higher during the spring and winter, diurnal temperature change is associated with testicular torsion. The diagnostic rate of color Doppler flow imaging is high, which can be chosen as the primary method. Prompt recognition and treatment are necessary for testicular salvage.

A nationwide epidemiological study of testicular torsion in Korea.

Testicular torsion is a surgical emergency in the field of urology. Knowledge of the epidemiology and pathophysiology is significant to an urologist. However, the epidemiology of testicular torsion in Korea has not been studied. We performed a nationwide epidemiological study to improve knowledge of the epidemiology of testicular torsion. From 2006-2011, the Korean Urologic Association began the patient registry service. The annual number of patients with testicular torsion from 2006 to 2011 were 225, 250, 271, 277, 345, and 210, respectively. The overall incidence of testicular torsion in males was 1.1 per 100,000; However, the incidence in men less than 25 yr old was 2.9 per 100,000. Adolescents showed the highest incidence. Total testicular salvage rate was 75.7% in this survey. There was no geographic difference of testicular salvage rate. Minimizing the possibility of orchiectomy for testicular torsion is important to improve public awareness to expedite presentation and provider education to improve diagnosis and surgery.

Seasonality of Testicular Torsion: A 10-Year Nationwide Population Based Study

Using a 10-year nationwide data set, we examined seasonal variability in the monthly incidence of testicular torsion in Taiwan. We also investigated the association between meteorological factors (ambient temperature, relative humidity, atmospheric pressure, rainfall and total hours of sunshine) and testicular torsion, stratified by age group. This study retrieved data from the National Health Insurance Research Database. We identified 1,782 hospitalizations for testicular torsion between 2000 and 2009. Spearman's rank correlation was used to explore possible associations between climatic parameters and the monthly incidence of testicular torsion. In addition, we used the ARIMA method (Auto-Regressive Integrated Moving Average) to test for seasonality in the incidence of testicular torsion. The results demonstrated a fairly similar seasonal pattern in monthly incidence rates for testicular torsion across both age groups and the combined groups. January (midwinter) had the highest rates, which decreased in April to a trough in June (early summer). After adjusting for the time trend effect and climatic parameters, the ARIMA regression revealed that January had a significantly higher monthly incidence of testicular torsion compared to February. In addition, our results indicated that the monthly incidence of testicular torsion was negatively associated with ambient temperature. Our results suggest that the monthly incidence of testicular torsion was significantly associated with seasonality and ambient temperature.

561 COLD WEATHER CAUSING TESTICULAR TORSION IS AN URBAN LEGEND

You have accessJournal of UrologyPediatrics: Congenital Anomalies - Lower Urinary Tract & Genitalia1 Apr 2011561 COLD WEATHER CAUSING TESTICULAR TORSION IS AN URBAN LEGEND Jessica T. Casey, Timothy B. Lautz, Lee C. Zhao, and Max Maizels Jessica T. CaseyJessica T. Casey Chicago, IL More articles by this author , Timothy B. LautzTimothy B. Lautz Chicago, IL More articles by this author , Lee C. ZhaoLee C. Zhao Chicago, IL More articles by this author , and Max MaizelsMax Maizels Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1286AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The etiology of testicular torsion is not well described. It has been hypothesized that colder temperatures cause asymmetric contraction of the cremaster muscle leading to asymmetric rotation with consequent twisting and elevation of the spermatic cord in susceptible patients. Consequently, testis torsion has come to be regarded as more common in colder months as an “urban legend” without evidence. Prior single institution studies on seasonal or temperature variation in the incidence of testicular torsion have not definitively answered this hypothesis. Our objective was to determine whether testicular torsion is more common in colder weather using a national pediatric dataset. METHODS Using the 2000, 2003 and 2006 Healthcare Cost and Utilization Project Kids' Inpatient Database (KID), testicular torsion events were identified using a diagnosis of torsion combined with a procedure for orchiopexy or orchiectomy. The percentage of cases occurring each month on a national and regional level was determined using both unweighted and weighted data. As some states do not have sufficient temperature variation to plausibly lead to testicular torsion, subgroup analysis was performed using only “cold states,” those having an average temperature <5° Celsius for ≥4 months per year. The hypothesis that the incidence of testicular torsion is higher in colder seasons than expected was tested with χ2 goodness of fit analysis. RESULTS There were 2413 episodes of testicular torsion among boys ≤18 years reported in the 2000, 2003 and 2006 KID: winter (26.9%), spring (25.7%), summer (23.5%) and fall (23.8%). This was not significantly different from the null hypothesis of equivalent distribution among the different seasons (p=0.06). At a regional level, the seasonal distribution of cases (winter, spring, summer, fall, respectively) was: Northeast (27.5%, 25.7%, 23.4%, 23.4%), Midwest (25.5%, 25.7%, 26.8%, 22.0%), South (26.8%, 25.7%, 23.2%, 24.3%) and West (27.2%, 25.8%, 22.1%, 24.9%). Limiting analysis to cold states, the distribution was winter 26.9%, spring 26.0%, summer 23.6%, and fall 23.5% (p=0.25). There was not significant variation in the monthly distribution of torsion events for all states and for cold states only. These data observations were unchanged when weighted national estimates were calculated for each month accounting for hospital strata, clustering and discharge weight. CONCLUSIONS Testicular torsion is evenly distributed across all seasons. The hypothesis that cold weather is related to the incidence of testicular torsion is not supported by data from a large representative national dataset. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e226-e227 Peer Review Report Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jessica T. Casey Chicago, IL More articles by this author Timothy B. Lautz Chicago, IL More articles by this author Lee C. Zhao Chicago, IL More articles by this author Max Maizels Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

562 OUTCOMES IN THE EVALUATION AND MANAGEMENT OF THE PERSISTENT/RECURRENT VARICOCELE

of the spermatic cord in susceptible patients. Consequently, testis torsion has come to be regarded as more common in colder months as an “urban legend” without evidence. Prior single institution studies on seasonal or temperature variation in the incidence of testicular torsion have not definitively answered this hypothesis. Our objective was to determine whether testicular torsion is more common in colder weather using a national pediatric dataset. METHODS: Using the 2000, 2003 and 2006 Healthcare Cost and Utilization Project Kids’ Inpatient Database (KID), testicular torsion events were identified using a diagnosis of torsion combined with a procedure for orchiopexy or orchiectomy. The percentage of cases occurring each month on a national and regional level was determined using both unweighted and weighted data. As some states do not have sufficient temperature variation to plausibly lead to testicular torsion, subgroup analysis was performed using only “cold states,” those having an average temperature 5° Celsius for 4 months per year. The hypothesis that the incidence of testicular torsion is higher in colder seasons than expected was tested with 2 goodness of fit analysis. RESULTS: There were 2413 episodes of testicular torsion among boys 18 years reported in the 2000, 2003 and 2006 KID: winter (26.9%), spring (25.7%), summer (23.5%) and fall (23.8%). This was not significantly different from the null hypothesis of equivalent distribution among the different seasons (p 0.06). At a regional level, the seasonal distribution of cases (winter, spring, summer, fall, respectively) was: Northeast (27.5%, 25.7%, 23.4%, 23.4%), Midwest (25.5%, 25.7%, 26.8%, 22.0%), South (26.8%, 25.7%, 23.2%, 24.3%) and West (27.2%, 25.8%, 22.1%, 24.9%). Limiting analysis to cold states, the distribution was winter 26.9%, spring 26.0%, summer 23.6%, and fall 23.5% (p 0.25). There was not significant variation in the monthly distribution of torsion events for all states and for cold states only. These data observations were unchanged when weighted national estimates were calculated for each month accounting for hospital strata, clustering and discharge weight. CONCLUSIONS: Testicular torsion is evenly distributed across all seasons. The hypothesis that cold weather is related to the incidence of testicular torsion is not supported by data from a large representative national dataset.

Neonatal testicular torsion – a lost cause?

Twenty-four neonates presented with signs of testicular ischaemia over a 13-year period. They had a mean birth weight of 3.706 kg. The right testicle was affected in 13, the left in 9 and there was bilateral torsion in 2 babies. Two babies had no twist in the cord, but the testicles were nonviable macroscopically and microscopically. Twenty-one babies had primary exploration revealing necrotic testes in all patients and they underwent orchidectomies. The other three babies had conservative management and the affected testes had atrophied on follow-up. Sixteen babies had contralateral orchidopexy. Doppler ultrasound scans were reported as normal in 2 of 13 babies who had scans. No testes were salvaged following surgery. The incidence of testicular torsion in the neonatal period was calculated as 6.1 per 100,000 live births. No testis was salvaged following surgery in our series of 24 patients. This dismal outcome underlines that immediate surgical exploration, although commonly performed, rarely saves torted testes.

Incidence of the bell-clapper deformityin an autopsy series

Objectives. Testicular torsion is seen in all age groups. The bell-clapper deformity (BCD) when present predisposes the patient to torsion. This study was undertaken to determine the incidence of the BCD. Methods. An autopsy series of 51 males with 101 testes was dissected by the senior author to determine the incidence of the BCD. Results. The manner of testicular investment by the tunica vaginalis was classified as normal, intermediate, or absent (BCD). Seventy-six testes were normal, 13 were intermediate, and 12 were of the bell-clapper type. Conclusions. The incidence of the BCD in this autopsy series was 12%. Because the incidenceof testicular torsion in the general population is far less than 12%, other factors in addition to anatomic predisposition must be involved.

Testicular Torsion and Low Relative Humidity in a Tropical Country

One hundred and thirty one patients with testicular torsion were reviewed retrospectively to investigate the association of testicular torsion with air temperature and low relative humidity in Zaria, Nigeria. The incidence of testicular torsion was significantly increased during the harmattan season (November to February), when relative humidity is low and temperature decreased. Relative humidity was more closely correlated with the incidence of testicular torsion than was air temperature. Testicular torsion is a major contributor to male infertility in Zaria, and further study of its causes is required.

Testicular torsion and low relative humidity in a tropical country.

One hundred and thirty one patients with testicular torsion were reviewed retrospectively to investigate the association of testicular torsion with air temperature and low relative humidity in Zaria, Nigeria. The incidence of testicular torsion was significantly increased during the harmattan season (November to February), when relative humidity is low and temperature decreased. Relative humidity was more closely correlated with the incidence of testicular torsion than was air temperature. Testicular torsion is a major contributor to male infertility in Zaria, and further study of its causes is required.

Testicular torsion in children: scintigraphic assessment

Seventy-five patients with suspected testicular torsion who had scintiscans and adequate clinical follow-up were analyzed retrospectively. The scintiscans diagnosed 12/13 cases of surgically proven missed torsion and 3/3 cases of surgically proven acute complete torsion. The scintiscans successfully distinguished all 35 cases of epididymo-orchitis, 14 cases of torsion of the appendix testes and 8 other miscellaneous conditions from testicular torsion. The incidence of testicular torsion in our patients undergoing scrotal scintigraphy was approximately 24%.