Abstracts of Papers Presented at The Regional Meeting of ASEA at Mazvikadeyi Conference Centre, Zimbabwe -April 2006.|
Torsion of the testis was described in 1840 by Delasiauve but it has taken a long time to get into the general awareness of doctors and be accepted as a relatively common and serious surgical emergency.The aim of this study was review the clinical features of testicular torsion, determine the pattern of pretorsion activity, the prevalence of testicular loss according to the referral pattern and the relationship between delay in management and testicular loss.
Parirenyatwa Central Hospital, Harare in Zimbabwe
A descriptive retrospective study of medical records of patients with a clinical diagnosis of testicular torsion that were seen in casualty and subsequently admitted in the period January 2001 to December 2003.
A total of 103 patients were included. The mean age was 20 +/- 5 years. There were no patients older than 40 years. The highest number of cases was recorded in the month of May. Two patients had torsion of the testicular appendage and 8 had epididymitis.In those patients were pre-torsion activity was recorded (n=35), the majority developed torsion at night while sleeping. Scrotal pain was present in 94% of the patients. Urinary symptoms were present in 8%.A history of previous scrotal pain was noted in 9%.Physical signs elicited included scrotal swelling (97%), testicular retraction (38%), erythema (36%) ,horizontal lie(1%), fever(17%) and tenderness(84%) .Radiological investigations were not used in the acute management of testicular torsion. The patients from private health facilities had the worst outcome with a rate of testicular loss of 80%, while 38% of peripheral hospital patients lost their testis and patients referred from family practitioners had 76% of their testis removed. The relationship between delay and outcome was demonstrated by a 25% testicular loss in those operated within 6 hours compared to 82% in those operated after 48hours of onset of torsion. The overall salvage rate was 38%.
The mean age was 20 years and the main symptoms were scrotal pain, nausea and vomiting. The physical signs were scrotal mass, tenderness and testicular retraction. Most patients developed torsion while sleeping. Testicular loss depends on the referral pattern. Delay in surgical exploration is directly related to testicular loss.