Mp21-19 cutoff time for surgery in spermatic cord torsion: results of a multicentric retrospective study of 2986 patients over 15 years

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation I (MP21)1 Sep 2021MP21-19 CUTOFF TIME FOR SURGERY IN SPERMATIC CORD TORSION: RESULTS OF A MULTICENTRIC RETROSPECTIVE STUDY OF 2986 PATIENTS OVER 15 YEARS Emilien Seizilles de Mazancourt, Xavier Matillon, Ugo Pinar, Igor Duquesne, Caroline Plassais, Thi Dang Van, Nadia Ali Benali, William Berchiche, Charles Gaillard, Anne Mauger de Varennes, Florian Bardet, Maud Hulin, Anthony Manuguerra, William Wandoren, Maxime Chabenes, Marc Sbizzera, Victor Gaillard, Francois Lannes, Ines Dominique, Lyon, France, Kevin Kaulanjan, Lucas Freton, Zine Eddine Khene, and Benjamin Pradere Emilien Seizilles de MazancourtEmilien Seizilles de Mazancourt More articles by this author , Xavier MatillonXavier Matillon More articles by this author , Ugo PinarUgo Pinar More articles by this author , Igor DuquesneIgor Duquesne More articles by this author , Caroline PlassaisCaroline Plassais More articles by this author , Thi Dang VanThi Dang Van More articles by this author , Nadia Ali BenaliNadia Ali Benali More articles by this author , William BerchicheWilliam Berchiche More articles by this author , Charles GaillardCharles Gaillard More articles by this author , Anne Mauger de VarennesAnne Mauger de Varennes More articles by this author , Florian BardetFlorian Bardet More articles by this author , Maud HulinMaud Hulin More articles by this author , Anthony ManuguerraAnthony Manuguerra More articles by this author , William WandorenWilliam Wandoren More articles by this author , Maxime ChabenesMaxime Chabenes More articles by this author , Marc SbizzeraMarc Sbizzera More articles by this author , Victor GaillardVictor Gaillard More articles by this author , Francois LannesFrancois Lannes More articles by this author , Ines DominiqueInes Dominique More articles by this author , Lyon, France Lyon, France More articles by this author , Kevin KaulanjanKevin Kaulanjan More articles by this author , Lucas FretonLucas Freton More articles by this author , Zine Eddine KheneZine Eddine Khene More articles by this author , and Benjamin PradereBenjamin Pradere More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002006.19AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Torsion of the spermatic cord is an urologic emergency. Data in scientific literature relies on small retrospective series. The objective of this study was to determine the cutoff time for surgery to avoid a surgical orchiectomy. METHODS: We performed a retrospective multicentric national study (TORSAFUF cohort) including patients from 14 hospital centers. Medical records from patients aged over 12 years old that had been operated for suspicion of spermatic cord torsion in the last fifteen years were analyzed. We collected information of medical history, demographic parameters, time of pain, time to the emergency unit and time to the operating room, final diagnosis after surgical exploration, surgical choice between orchidopexy and orchiectomy. Patients for whom the time between the start of the symptoms and operating time was not available were excluded from the study. RESULTS: Between 2005 and 2020, 2986 patients had a surgical exploration for spermatic cord suspicion in 14 hospital centers. 1802 (60%) patients had a final diagnosis of spermatic cord torsion et 220 (7%) required surgical orchiectomy. Time between the beginning of the pain and the surgical intervention was available for 1266 patients with a final diagnosis of spermatic cord torsion and was of an average 17 hours. Average time to surgical exploration was of 11 hours in the group orchidopexy (n=1117) and 65 hours in the orchidectomy group (n=149) (p<0.001). A conservative treatment (orchidopexy) was performed in 99% of the spermatic cord torsions that were operated in the first six hours whereas it was performed in 95% of the spermatic cord torsions operated after 6 to 12 hours (p<0.001). Over 24 hours of pain duration for a confirmed spermatic cord torsion, the rate of orchidectomy was 54%. CONCLUSIONS: The probability of orchidectomy grows with pain duration. The time limit for surgical exploration of 6 hours after the start of pain seems to be a reasonable cutoff to avoid orchiectomy. Source of Funding: No source of funding © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e353-e354 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emilien Seizilles de Mazancourt More articles by this author Xavier Matillon More articles by this author Ugo Pinar More articles by this author Igor Duquesne More articles by this author Caroline Plassais More articles by this author Thi Dang Van More articles by this author Nadia Ali Benali More articles by this author William Berchiche More articles by this author Charles Gaillard More articles by this author Anne Mauger de Varennes More articles by this author Florian Bardet More articles by this author Maud Hulin More articles by this author Anthony Manuguerra More articles by this author William Wandoren More articles by this author Maxime Chabenes More articles by this author Marc Sbizzera More articles by this author Victor Gaillard More articles by this author Francois Lannes More articles by this author Ines Dominique More articles by this author Lyon, France More articles by this author Kevin Kaulanjan More articles by this author Lucas Freton More articles by this author Zine Eddine Khene More articles by this author Benjamin Pradere More articles by this author Expand All Advertisement Loading ...