Testicular Torsion as seen in University of Maiduguri Teaching Hospital, North Eastern Nigeria

Abstract

Background: Testicular torsion is one of the commonest urological emergencies affecting adolescents and young adults worldwide. Favourable outcome depends on severity and timely intervention. Delayed presentation, missed diagnoses and prolonged reaction time are associated with high testicular loss due to gangrene while the reverse is associated with high testicular salvage rate. Materials and Methods: We retrospectively reviewed all cases of testicular torsion in University of Maiduguri Teaching Hospital [UMTH] between January 2008 and December 2011. Information was obtained from clinical notes and laboratory investigations. Results: A total of 56 patients were studied. The age ranged from 11-35 years with a mean of 23+ 17.5 years. Majority (91%) of the patient were in their second and third decades. Most, 41 (73.21%) presented during the cold harmattan season (November to February). Only 11 (19.64%) presented within golden 4 hours from onset of symptoms, 30 (53.56%) between 4 to 24 hours while 15(26.79%) presented beyond 24 hours. Twenty-two (39.29%) had scrotal exploration within 4 hours of presentation to the emergency unit, while 26 (46.43%) within 4 to 12 hours, and 8 (14.29%) had delay beyond 12 hours. The study found associated anomalies in the torted testes which includes horizontal lie 9( 13.85%), long mesochium 5(7.69%), hydrocele 4 (6.15%), and 1(1.54%) each of hernia, varicocele, atrophy and patent processus vaginalis. There was no mortality and morbidity was limited to minor surgical site wound infection. Conclusion: High index of suspicion, prompt and adequate intervention were associated with high testicular salvage rate.