Impediments to salvage of the testis after torsion in a Nigerian tertiary hospital

Abstract

Background: Testicular torsion is fraught with the risk of losing the testis if prompt surgical intervention is not instituted. The salvage rates for testis after torsion have been found to vary across the globe.

Objective: To determine factors affecting the salvage rate of testis following testicular torsion at the University of Port Harcourt Teaching Hospital (UPTH).

Design: A prospective descriptive study

Setting: University of Port Harcourt Teaching Hospital

Subjects: Sixty eight patients who presented with testicular torsion in our hospital from between 2012 and 2015.

Intervention: Detorsion and orchidopexy for viable testis. Orchidectomy for gangrenous testis.

Main outcome measures: Size of testis after orchidopexy.

Results: Sixty-eight patients were treated within the period. The mean age of the patients was 24.6 ± 5.5years. Most patients (n=44; 64.7%) presented between the ages of 21 to 30years. The most common presenting complaint was testicular pain (n=64; 94.12%). Only six patients (8.82%) presented within 6 hours. Eighteen patients (26.47%) first presented to patent medical attendants. Thirty-three patients (48.53%) presented with acute testicular torsion. Thirty-two patients (47.06%) had orchidectomy while 36(52.94%) had orchidopexy. Thirty-two (47.06%) had immediate testicular loss, while twenty-four (35.29%) had satisfactory outcome. Factors associated with testicular loss were presentation after 24hours (p=0.001), and initial treatment by a patent medical attendant and general medical practitioners.

Conclusion: Low salvage rate after testicular torsion due to delayed presentation to appropriate health facility was noted in Port Harcourt. Health education and increased awareness even amongst doctors would help improve the salvage rate.