In emergency settings, does the use of testicular pulse oximetry aid diagnosis of testicular torsions?

Abstract

Pulse oximetry is a non-invasive and inexpensive method of detecting oxygenation, which could help to reduce unnecessary scrotal exploration and expedite diagnosis if shown to be accurate in patients with suspected testicular torsion. A short systematic review was conducted to address the following three-part question: in emergency settings, can the use of testicular pulse oximetry aid the diagnosis of testicular torsion?The Medline, Embase and Cochrane databases were searched using the Ovid interface on 29 January 2025. The search included papers from 1946 on Medline, from 1974 on Embase and from 1998 on Cochrane. The search strategy yielded one study that directly answered the three-part question. Study information, participant group, relevant outcomes and study weaknesses were extracted.The only study identified was a case series including 16 participants. Results showed that oxygen saturation and pulse rate were undetectable in all torted testes but detectable in all unaffected testes. However, due to the small sample size, the results of this study cannot be reliably extrapolated to a wider population. This review excluded research articles where near-infrared spectroscopy was used rather than pulse oximetry to characterise testicular blood flow, though that technology may also show future promise.The clinical bottom line is that there is currently insufficient evidence for the use of pulse oximetry in this context. However, the evidence identified suggests that the technique shows promise, particularly for use in resource-poor environments.