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Doppler ultrasound improves diagnostic accuracy for testicular torsion

Teurneau-Hermansson, Karl LU orcid ; Zindovic, Igor LU ; Jakobsson, Jon ; Navntoft, Anders ; Nozohor Ekmark, Ann ; Salö, Martin LU and Wagenius, Magnus LU (2021) In Scandinavian Journal of Urology 55(6). p.461-465
Abstract

Background: Doppler ultrasound can diagnose testicular torsion with high sensitivity and specificity but may delay surgical treatment. This study aims to assess whether the use of doppler ultrasound, in cases with intermediate clinical suspicion of testicular torsion, can improve diagnostic accuracy compared to clinical assessment alone. Methods: We implemented a new clinical algorithm where patients with intermediate suspicion of testicular torsion undergo doppler ultrasound within 60 min. This study compared the patients that presented within one year prior to the implementation (group 1) to the patients who presented within one year after the implementation (group 2). The primary outcome measure was failure to confirm testicular... (More)

Background: Doppler ultrasound can diagnose testicular torsion with high sensitivity and specificity but may delay surgical treatment. This study aims to assess whether the use of doppler ultrasound, in cases with intermediate clinical suspicion of testicular torsion, can improve diagnostic accuracy compared to clinical assessment alone. Methods: We implemented a new clinical algorithm where patients with intermediate suspicion of testicular torsion undergo doppler ultrasound within 60 min. This study compared the patients that presented within one year prior to the implementation (group 1) to the patients who presented within one year after the implementation (group 2). The primary outcome measure was failure to confirm testicular torsion upon surgical exploration (negative surgical exploration). Missed testicular torsion was one of the secondary endpoints. Results: 590 consecutive patients were included. 322 (55%) in group 1 and 268 (45%) in group 2. There were 9 (2.8%) testicular torsions in group 1 vs 9 (3.4%) in group 2 (p = 0.69) and 2 (0.6%) missed testicular torsions in group 1 vs 0 in group 2 (p = 0.50). Doppler ultrasound was performed in 65 patients (24.2%) in group 2 vs 0 in group 1 (p < 0.01). Negative surgical exploration was performed in 27 (8.4%) patients in group 1 vs 8 (3.0%) in group 2 (p < 0.01). Conclusion: Doppler ultrasound assessment of patients at intermediate clinical risk of testicular torsion significantly reduced the frequency of negative surgical explorations without increased rate of missed testicular torsions.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Doppler ultrasound, scrotal pain, Testicular torsion
in
Scandinavian Journal of Urology
volume
55
issue
6
pages
461 - 465
publisher
Taylor & Francis
external identifiers
  • scopus:85112057109
  • pmid:34369846
ISSN
2168-1805
DOI
10.1080/21681805.2021.1962404
language
English
LU publication?
yes
id
6ca29ef2-ba5d-44ac-a089-ee674adadda9
date added to LUP
2021-09-02 17:11:47
date last changed
2024-06-15 15:36:43
@article{6ca29ef2-ba5d-44ac-a089-ee674adadda9,
  abstract     = {{<p>Background: Doppler ultrasound can diagnose testicular torsion with high sensitivity and specificity but may delay surgical treatment. This study aims to assess whether the use of doppler ultrasound, in cases with intermediate clinical suspicion of testicular torsion, can improve diagnostic accuracy compared to clinical assessment alone. Methods: We implemented a new clinical algorithm where patients with intermediate suspicion of testicular torsion undergo doppler ultrasound within 60 min. This study compared the patients that presented within one year prior to the implementation (group 1) to the patients who presented within one year after the implementation (group 2). The primary outcome measure was failure to confirm testicular torsion upon surgical exploration (negative surgical exploration). Missed testicular torsion was one of the secondary endpoints. Results: 590 consecutive patients were included. 322 (55%) in group 1 and 268 (45%) in group 2. There were 9 (2.8%) testicular torsions in group 1 vs 9 (3.4%) in group 2 (p = 0.69) and 2 (0.6%) missed testicular torsions in group 1 vs 0 in group 2 (p = 0.50). Doppler ultrasound was performed in 65 patients (24.2%) in group 2 vs 0 in group 1 (p &lt; 0.01). Negative surgical exploration was performed in 27 (8.4%) patients in group 1 vs 8 (3.0%) in group 2 (p &lt; 0.01). Conclusion: Doppler ultrasound assessment of patients at intermediate clinical risk of testicular torsion significantly reduced the frequency of negative surgical explorations without increased rate of missed testicular torsions.</p>}},
  author       = {{Teurneau-Hermansson, Karl and Zindovic, Igor and Jakobsson, Jon and Navntoft, Anders and Nozohor Ekmark, Ann and Salö, Martin and Wagenius, Magnus}},
  issn         = {{2168-1805}},
  keywords     = {{Doppler ultrasound; scrotal pain; Testicular torsion}},
  language     = {{eng}},
  number       = {{6}},
  pages        = {{461--465}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Urology}},
  title        = {{Doppler ultrasound improves diagnostic accuracy for testicular torsion}},
  url          = {{http://dx.doi.org/10.1080/21681805.2021.1962404}},
  doi          = {{10.1080/21681805.2021.1962404}},
  volume       = {{55}},
  year         = {{2021}},
}