Cut-off time for surgery and prediction of orchiectomy in spermatic cord torsion: a retrospective multicentric study over 15 years.


Journal

World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716

Informations de publication

Date de publication:
Dec 2023
Historique:
received: 29 08 2023
accepted: 26 09 2023
medline: 4 12 2023
pubmed: 29 10 2023
entrez: 28 10 2023
Statut: ppublish

Résumé

Cut-off time to avoid orchiectomy relies on small series of patients. The objective was to determine the cut-off time to avoid orchiectomy in torsion of the spermatic cord in a large cohort. We performed a retrospective multicenter study (TORSAFUF cohort) of patients with suspected spermatic cord torsion between 2005 and 2019. All patients aged > 12 years who were suspected of having a torsion of the spermatic cord in 14 University Hospitals in France were included (n = 2986). Patients for whom data on pain duration were not available (n = 923) or for whom the final diagnosis was not torsion of the spermatic cord (n = 807) were excluded. The primary outcome was orchiectomy. The secondary outcomes were testicular survival time and the prediction of orchiectomy with the duration of pain. 1266 patients were included with an orchiectomy rate of 12% (150 patients). The mean age was 21.5 years old in the salvage group and 23.7 years old in the orchiectomy group (p = 0.01), respectively. The median time from the onset of pain to surgery was 5.5 (IQR = 5) hours in the salvage group and 51.1 (IQR = 70) hours in the orchiectomy group (p < 0.0001). The risk of orchiectomy increased after a time cut-off of 6 h 30. A delay of 15 h 30 in pain duration was found to predict orchiectomy (sensitivity: 0.81; specificity: 0.87). Pain duration can predict the probability of salvaging the testicles and performing orchiectomy. Rapid intervention should be recommended, regardless of the time elapsed from the onset of pain.

Identifiants

pubmed: 37897515
doi: 10.1007/s00345-023-04671-x
pii: 10.1007/s00345-023-04671-x
doi:

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3789-3794

Informations de copyright

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Références

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Auteurs

Emilien Seizilles de Mazancourt (E)

Urology and Transplantation Surgery, Edouard Herriot Hospital, Lyon, France. emilien.mazancourt@hotmail.fr.
Univ Lyon, Université Claude Bernard Lyon 1, Lyon, France. emilien.mazancourt@hotmail.fr.

Zinnedine Khene (Z)

Department of Urology, Rennes University Hospital, Rennes, France.

Marc Sbizerra (M)

Department of Urology, Lyon Sud Hospital, Lyon, France.

Kevin Kaulanjan (K)

Department of Urology, Pointe A Pitre University Hospital, Guadeloupe, France.

Caroline Plassais (C)

Department of Urology, APHP, Hôpitaux Universitaires Pitie-Salpetriere-Charles Foix, Sorbonne Université, Paris, France.

Florian Bardet (F)

Department of Urology, Dijon University Hospital, Dijon, France.

Ugo Pinar (U)

Department of Urology, APHP, Hôpitaux Universitaires Pitie-Salpetriere-Charles Foix, Sorbonne Université, Paris, France.

Igor Duquesne (I)

Department of Urology, APHP, Hôpital Cochin, Université de Paris, Paris, France.

Gaelle Margue (G)

Department of Urology, Bordeaux University Hospital, Bordeaux, France.

Nadia Ali Benali (N)

Department of Urology, Poitiers University Hospital, Poitiers, France.

William Berchiche (W)

Department of Urology, La Conception University Hospital, Marseille, France.

Charles Gaillard (C)

Department of Urology, Tours University Hospital, Tours, France.

William Wandoren (W)

Department of Urology, Pointe A Pitre University Hospital, Guadeloupe, France.

Anthony Manuguerra (A)

Department of Urology, Nancy University Hospital, Nancy, France.

Van Thi Dang (VT)

Department of Urology, Toulouse University Hospital, Toulouse, France.

Anne Mauger de Varennes (A)

Department of Urology, Rennes University Hospital, Rennes, France.

Maud Hulin (M)

Department of Urology, Reims University Hospital, Reims, France.

Victor Gaillard (V)

Department of Urology, Strasbourg University Hospital, Strasbourg, France.

Ines Dominique (I)

Department of Urology, Lyon Sud Hospital, Lyon, France.

Clement Michiels (C)

Department of Urology, Bordeaux University Hospital, Bordeaux, France.

Tristan Grevez (T)

Department of Urology, Tours University Hospital, Tours, France.

Margaux Felber (M)

Department of Urology, APHP, Hôpitaux Universitaires Pitie-Salpetriere-Charles Foix, Sorbonne Université, Paris, France.

Maxime Vallee (M)

Department of Urology, Poitiers University Hospital, Poitiers, France.

Bastien Gondran-Tellier (B)

Department of Urology, La Conception University Hospital, Marseille, France.

Lucas Freton (L)

Department of Urology, Rennes University Hospital, Rennes, France.

François Lannes (F)

Department of Urology, La Conception University Hospital, Marseille, France.

Benjamin Pradère (B)

Department of Urology, Toulouse University Hospital, Toulouse, France.

Xavier Matillon (X)

Urology and Transplantation Surgery, Edouard Herriot Hospital, Lyon, France.

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