학술논문
Doppler ultrasound improves diagnostic accuracy for testicular torsion.
Document Type
Academic Journal
Author
Teurneau-Hermansson K; Department of Urology, Helsingborg Hospital, Helsingborg, Sweden.; Zindovic I; Department of Cardiothoracic Surgery, Skåne University Hospital, Lund University, Lund, Sweden.; Jakobsson J; Department of Urology, Helsingborg Hospital, Helsingborg, Sweden.; Navntoft A; Department of Radiology, Helsingborg Hospital, Helsingborg, Sweden.; Nozohor Ekmark A; Department of Pediatric Surgery, Skåne University Hospital, Lund, Sweden.; Salö M; Department of Pediatric Surgery, Skåne University Hospital, Lund, Sweden.; Wagenius M; Department of Urology, Helsingborg Hospital, Helsingborg, Sweden.
Source
Publisher: Medical Journals Sweden AB Country of Publication: Sweden NLM ID: 101587186 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2168-1813 (Electronic) Linking ISSN: 21681805 NLM ISO Abbreviation: Scand J Urol Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Doppler ultrasound can diagnose testicular torsion with high sensitivity and specificity but may delay surgical treatment. This study aims to assess whether the use of doppler ultrasound, in cases with intermediate clinical suspicion of testicular torsion, can improve diagnostic accuracy compared to clinical assessment alone.
Methods: We implemented a new clinical algorithm where patients with intermediate suspicion of testicular torsion undergo doppler ultrasound within 60 min. This study compared the patients that presented within one year prior to the implementation (group 1) to the patients who presented within one year after the implementation (group 2). The primary outcome measure was failure to confirm testicular torsion upon surgical exploration (negative surgical exploration). Missed testicular torsion was one of the secondary endpoints.
Results: 590 consecutive patients were included. 322 (55%) in group 1 and 268 (45%) in group 2. There were 9 (2.8%) testicular torsions in group 1 vs 9 (3.4%) in group 2 ( p = 0.69) and 2 (0.6%) missed testicular torsions in group 1 vs 0 in group 2 ( p = 0.50). Doppler ultrasound was performed in 65 patients (24.2%) in group 2 vs 0 in group 1 ( p < 0.01). Negative surgical exploration was performed in 27 (8.4%) patients in group 1 vs 8 (3.0%) in group 2 ( p < 0.01).
Conclusion: Doppler ultrasound assessment of patients at intermediate clinical risk of testicular torsion significantly reduced the frequency of negative surgical explorations without increased rate of missed testicular torsions.
Methods: We implemented a new clinical algorithm where patients with intermediate suspicion of testicular torsion undergo doppler ultrasound within 60 min. This study compared the patients that presented within one year prior to the implementation (group 1) to the patients who presented within one year after the implementation (group 2). The primary outcome measure was failure to confirm testicular torsion upon surgical exploration (negative surgical exploration). Missed testicular torsion was one of the secondary endpoints.
Results: 590 consecutive patients were included. 322 (55%) in group 1 and 268 (45%) in group 2. There were 9 (2.8%) testicular torsions in group 1 vs 9 (3.4%) in group 2 ( p = 0.69) and 2 (0.6%) missed testicular torsions in group 1 vs 0 in group 2 ( p = 0.50). Doppler ultrasound was performed in 65 patients (24.2%) in group 2 vs 0 in group 1 ( p < 0.01). Negative surgical exploration was performed in 27 (8.4%) patients in group 1 vs 8 (3.0%) in group 2 ( p < 0.01).
Conclusion: Doppler ultrasound assessment of patients at intermediate clinical risk of testicular torsion significantly reduced the frequency of negative surgical explorations without increased rate of missed testicular torsions.