Public awareness of testicular torsion is lacking in Edmonton.

Abstract

Introduction: The time from symptom onset to intervention dictates morbidity in testicular torsion (TT). Delayed presentation negatively impacts surgical outcomes and poor knowledge about TT is hypothesized to be a potential cause of delay. Our study characterizes baseline public awareness rates among families in Edmonton and assesses the association between awareness and TT outcomes.

Methods: Patients and their caregivers completed surveys assessing TT awareness. Families were surveyed in two groups: those who presented with TT and age-matched controls. Affected families gave additional information about symptoms, time to notify parents, and present to the hospital. Outcomes were assessed at followup and through medical record review.

Results: Of 61 families, 18 (29.5%) patients and 22 (36.1%) parents had heard of TT. Among TT-affected patients (n=30), time to report symptoms (3.2 vs. 20.5 hours, p<0.01) and to arrive at hospital (3.0 vs. 20.8 hours, p<0.01) was significantly longer for patients requiring orchiectomy. Total time (odds ratio [OR] 0.992, p=0.01) and pain (OR 0.904, p=0.05) were associated with outcome. No differences in awareness were seen between patients who underwent orchiopexy vs. orchiectomy (23.8% vs. 25.0%, p>0.99).

Conclusions: We demonstrate that most Edmonton families have never heard of TT and that the pre-admission interval constitutes a substantial proportion of delays in surgery. Although time and pain ratings were associated with outcomes in TT, further evidence is required to demonstrate that awareness impacts outcomes significantly.