Testicular Salvage Rate among Patients with Testicular Torsion in Abuja, Nigeria
Main Article Content
Keywords
Testicular torsion, salvage rate, orchidopexy, orchidectomy
Abstract
Background: Testicular torsion (TT) represents a critical urological emergency characterized by the twisting of the spermatic cord necessitating immediate surgical intervention to prevent irreversible ischemic damage to the testis. The testicular salvage rate (TSR) is influenced by demographic, logistical, and institutional factors. However, there is a paucity of data on this subject in our setting. The study aims to determine the TSR among patients who had TT at Federal Medical Centre, Abuja, and to clinically review the presentations and outcomes of surgical intervention of this urologic emergency.
Methodology: We retrospectively reviewed the electronic medical records (EMRs) of all patients who had emergency scrotal exploration for testicular torsion between December 2022 and November 2025. The demographics, clinical presentation, intraoperative findings, procedures performed, and surgical outcomes were documented and analyzed.
Results: A total of 46 patients with TT had scrotal exploration within the study period. Their mean age was 20.3 ± 6.5 years, with an age range of 5- 39 years. The peak age group was 11-20 years. The right-to-left laterality ratio was 1.6: 1. No statistically significant difference was found in the monthly incidence of torsion. Only 13(28.3%) presented within the 6 hours of onset of symptoms, while long mesorchium was the most common anatomic predisposing factor identified (n=21, 45.7%). The commonest associated symptom was abdominal pain (32.6%). Of the 18 patients who had orchidectomy, 12 had ≥540-degree twist of their spermatic cords and gangrene of testes. The testicular salvage rate was 67.4%. Median hospital stay was 1 day (range 1-4 days)
Conclusion: Despite more than 70% of our patients presenting with delays, prompt surgical intervention achieved a salvage rate of 67.4%. Further research is necessary to investigate the long-term outcomes for patients post-salvage and evaluate the functional efficacy of the preserved tissue.
References
2. Eisenberg, M. et al. (2020). The impact of timely surgical intervention on testicular salvage rates: A multicenter analysis. Pediatric Emergency Care, 36(2), 67-71.
3. Omisanjo O, Ikuerowo SO, Bioku MJ, Esho JO, 2012, Torsion of the testis in Lagos: a five-year experience, Nigerian Journal of Urology; 1:24-27
4. Obi AO, Okeke, CJ, Ugwuidu, EI. Acute Testicular Torsion: A Critical Analysis of Presentation, Management and Outcome in Southeast Nigeria. Nigerian Journal of Clinical Practice 23(11): p 1536-1541, November 2020. | DOI: 10.4103/njcp.njcp_188_20
5. Ghosh, A. et al. (2017). Testicular torsion: A review of the literature and the current state of management. Urology Annals, 9(3), 125-130.
6. Hoffman, B. et al. (2018). Time-dependent outcomes in testicular torsion: A nationwide analysis of surgical outcomes. BJU International, 121(4), 614-620.
7. Kumar, A. et al. (2020). Testicular torsion: A critical review of the current literature and management strategies. International Journal of Surgical Case Reports, 68, 49-54.
8. Mason, C. et al. (2019). Epidemiology and management of testicular torsion in pediatric patients: A cohort study. Journal of Pediatric Urology, 15(5), 490.e1-490.e5.
9. Perry, A. et al. (2021). Testicular torsion in adolescents: Outcomes of surgical management and factors affecting testicular salvage. Journal of Pediatric Surgery, 56(6), 1099-1105.
10. Ugwu BT, Dakum NK, Yiltok SJ, Mbah N, Legbo JN, Uba AF, Orkar KS, Ramyil VM. Testicular torsion on the Jos Plateau. West Afr J Med. 2003 Jun;22(2):120-3. doi: 10.4314/wajm. v22i2.27929. PMID: 14529218
11. Magoha GA. Testicular torsion salvage rate in Nigerians in Lagos. East African Medical Journal. 1989 May;66(5):324-327. PMID: 2791929.
12. Njeze, Gabriel E. Testicular torsion: Needless testicular loss can be prevented. Nigerian Journal of Clinical Practice 15(2): p 182-184, Apr–Jun 2012. | DOI: 10.4103/1119-3077.97311
13. Hoffman, R. M., et al. (2017). Testicular torsion: a review of the literature. Urology, 107, 1-5.
14. Koifman, L., et al. (2018). "The right testis is more frequently affected by torsion: An analysis of 498 cases." Urology Annals, 10(2), 187-191.
15. Ugwumba FO, Okoh AD, Echetabu KN. Acute and intermittent testicular torsion: Analysis of presentation, management and outcome in South East, Nigeria, Niger J Clin Pract. 2016; 19:407–10
16. Jones DJ, Macreadie D, Morgans T. Testicular torsion in the armed services: Twelve-year review of 179 cases Br J Surg. 1986;73:624–6
17. Skoglund RW, McRoberts JW, Ragde H. Torsion of the spermatic cord: A review of the literature and an analysis of 70 new cases J Urol. 1970;104:604–7
18. Takure AO, Shittu OB, Adebayo SA, Okeke LO, Olapade-Olaopa EO. Torsion of the testis and factors that determine the choice of orchidectomy and unilateral orchidopexy Niger Postgrad Med J. 2013;20: 197–202
19. Kreiger, S. S., et al. (2015). Seasonal variation in the presentation of testicular torsion. Journal of Urology, 193(2), 479-482.
20. Gomes Dde O, Vidal RR, Foeppel BF, Faria DF, Saito M, Cold weather is a predisposing factor for testicular torsion in a tropical country. A retrospective study, Sao Paulo Med J, 133 (3) (2015), pp. 187-190
21. Korkes F, Cabral PR, Alves CD, Savioli ML, Pompeo AC. Testicular torsion and weather conditions: analysis of 21,289 cases in Brazil. Int Braz J Urol, 38 (2) (2012), pp. 222-228
22. Driscoll PA, Brume J, Meehan SE. Cold weather and testicular torsion
Br Med J, 286 (6379) (1983), p. 175
23. Kim, C. S., et al. (2020). "Anatomical causes of testicular torsion: A review." *International Urology and Nephrology*, 52(4), 575-581.
24. Obi AO, Aghaji AE. Torsion of the spermatic cord. Is bilateral orchidopexy really necessary? J Coll Med 2003; 8:42‑4.
25. Lindsey D, Stanisic TH. Diagnosis and management of testicular torsion: Pitfalls and perils. Am J Emerg Med 1988; 6:42‑6.
26. Elliott, T. S., et al. (2019). Timing of surgical intervention and testicular salvage in acute testicular torsion: A systematic review. British Journal of Urology International*, 123(3), 452-45
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open-access journal and articles are distributed under the terms of the Creative Commons Attribution Non-Commercial Share-Alike License 4.0. This licence allows users to download and share, remix, tweak and build upon the article for non-commercial purposes, so long as the original authorship is acknowledged and the new creations are licensed under identical terms.