Anesthetic management of testicular torsions and seasonal distribution: 5-year analysis

Testicular torsion (TT) occurs when the testis rotates around the spermatic cord. It is a urological emergency that may result in the testicular loss if medical intervention is not immediately available. The anesthetic management of cases of TT operated in our clinic within five years and the results of their seasonal distribution have been discussed with the current literature. Material and Method: Fifty-seven patients, who were operated for TT by urology clinics at our hospital between January 2013 and December 2018, were included in the study. Patients were divided into two groups (group1: detorsion, group2: and orchiectomy) according to the surgical operation we underwent. Patient demographic data, the elapsed time from onset of symptoms to operation, ASA scores, anesthetic method, duration of hospital stay and seasonal distribution of cases were examined. Results: The mean age of the 50 patients operated due to testicular torsion was 19.86 ± 13.23 years. We used general anesthesia in 32 (64%) patients and spinal anesthesia in 18 (36%) patients. Detorsion was performed in 38 patients (76%) and orchiectomy in 12 patients (24%). The time elapsed from the onset of symptoms to the operation was 16.1 hours in patients undergoing detorsion and 30.1 hours in patients undergoing orchiectomy (p <0.05). The seasonal distribution shows that 6 patients (12%) were observed in summer, 20 (40%) in autumn, 9 (18%) in winter and 15 (30%) in spring. The incidence was higher in the cold weather conditions, but the difference was not statistically significant. There was no perioperative morbidity and mortality in the patients. Conclusion: Suspected testicular torsion is a seasonindependent clinical picture. In these cases where the time from the onset of symptoms to the operation is short, detorsion is sufficient. It is a patient population suitable for outpatient treatment, as the length of hospital stay is short.