Descripción de factores clínicos asociados a la torsión testicular

Introduction Testicular torsion is a urological emergency that affects 4.5 out of 100,000 men under 25 years. It requires prompt diagnosis and intervention within the first 4 to 6 hours to avoid irreversible loss of testicular parenchyma. Objective To describe the most important signs and symptoms in the diagnosis of testicular torsion. Materials and Methods We extracted information from the clinical records of patients who consulted to the emergency department between January 2010 and January 2015. The analyzed variables were: age, laterality, related symptoms, physical examination findings and intraoperative findings. The variables were evaluated by bivariate analysis. Results A total of 117 patients presented with testicular torsion: age range was between 10 and 18 years, 67% of cases (p ¼ 0.0001). In the physical exam increased hemiscrotum size was present in 85% (p ¼ 0.046), an ascended position was seen in 60% (p ¼ 0.048) and 67% were horizontalized (p ¼ 0.004). Pain described as “pulsatile” was the most common type in 63.4% of the cases (p ¼ 0.028). Those who consulted within the first 12 hours had a better outcome (p ¼ 0.0001), as well as those intervened within the first 6 hours (p ¼ 0.049). Conclusions Clinical presentation alone can make the diagnosis of testicular torsion. Cremasteric reflex and presentation of previous episodes of orchyialgia should be evaluated more thoroughly in future studies. It is important to educate the general practitioners and the patient in the diagnosis of testicular torsion to improve attention and intervention time to improve patient prognosis.