Does Pediatric Fellowship Training Result in Higher Rates of Salvage in Acute Testicular Torsion?

Abstract

Objective: To evaluate whether pediatric urology fellowship training affects testicular salvage rates.

Methods: A retrospective chart review was conducted for pediatric patients diagnosed with acute testicular torsion between January 2017 and January 2023. Data including age, transfer status, imaging, transportation mode, symptom duration, and surgical outcomes were analyzed. Salvage was defined as orchiopexy at time of intervention without subsequent atrophy on follow-up exam.

Results: Of 62 patients, the mean age was 12 years. Pediatric urologists performed 57.1% of the surgeries. Pediatric urologists were significantly more likely to salvage the torsed testis and perform bilateral orchiopexies (P = .003), but there was no significant difference when accounting for atrophy on follow-up exam (P = .27). The majority (71%) of patients were transfers from outside facilities, and 67% were from facilities within 16 miles of the treating facility. No complications were noted at the time of surgery or during the follow-up period.

Conclusion: Pediatric urologists more often perform bilateral orchiopexy compared to urologists without pediatric fellowship training, but there was no difference in testicular atrophy rates at 3-month follow up. This study supports the idea that timely intervention remains the most important factor affecting testicular salvage.