Impact Of Delayed Intervention In Testicular Torsion A Retrospective Cohort Study O Outcomes In Emergency Settings

Abstract

Background:
Testicular torsion (TT) represents a crucial urological emergency because delayed medical care produces testicular necrosis and infertility together with persistent complications. The improvement of testicular salvage depends on performing surgery at the correct time. The diagnosis and treatment process of testicular torsion in emergency settings influences severely the clinical results when patients seek care too late.

Objectives:
A study aims to determine the effects that delayed surgical intervention has on testicular salvage rates and postoperative health complications including fertility outcomes for patients who suffer testicular torsion.

Study design: A Retrospective Cohort Study.

Place and duration of study: Department of Urology, Rehman Medical Institute Peshawar from January 2018 to December 2021.

Methods:
100 testicular torsion patients from January 2018 until January 2021. Study gathered information about symptom development together with patients' delay before hospital arrival and subsequent treatment procedures. The study divided patients into two groups based on when they received intervention care either before or after the six-hour mark. SPSS version 24.0 performed the statistical analysis where significance appeared at p<0.05.

Results:
On average patients reached 24.6 ± 9.7 years in age. Previously administered care within six hours of trauma maintained testicular preservation at a rate of 94% while treatment provided past six hours reduced success to 60%. The patients who received delayed intervention faced scrotal gangrene in 15% of cases and infections in 5% of cases. The fertility outcome in patients who received delayed intervention (after 6 hours) was characterized by an 82% reduction compared to the early intervention patients (95%). The statistical value of testicular salvage reached a probability level of below 0.01.

Conclusion:
Testicular salvage success declines along with increasing complications when treatment for testicular torsion occurs with delays. The preservation of fertility together with a reduction of morbidity requires immediate surgical intervention.