Mp35-14 the use of doppler ultrasound for suspected testicular torsion: lessons learned from a 15-year multicentre retrospective study of 2922 patients

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia (MP35)1 Sep 2021MP35-14 THE USE OF DOPPLER ULTRASOUND FOR SUSPECTED TESTICULAR TORSION: LESSONS LEARNED FROM A 15-YEAR MULTICENTRE RETROSPECTIVE STUDY OF 2922 PATIENTS Ugo Pinar, Igor Duquesne, François Lannes, Florian Bardet, Kévin Kaulanjan, Clément Michiels, Emilien Seizilles de Mazancourt, Maxime Vallee, Margaux Felber, Lucas Freton, William Berchiche, Caroline Plassais, Bastien Gondran-Tellier, Xavier Matillon, Zine-Eddine Khene, and Benjamin Pradere Ugo PinarUgo Pinar More articles by this author , Igor DuquesneIgor Duquesne More articles by this author , François LannesFrançois Lannes More articles by this author , Florian BardetFlorian Bardet More articles by this author , Kévin KaulanjanKévin Kaulanjan More articles by this author , Clément MichielsClément Michiels More articles by this author , Emilien Seizilles de MazancourtEmilien Seizilles de Mazancourt More articles by this author , Maxime ValleeMaxime Vallee More articles by this author , Margaux FelberMargaux Felber More articles by this author , Lucas FretonLucas Freton More articles by this author , William BerchicheWilliam Berchiche More articles by this author , Caroline PlassaisCaroline Plassais More articles by this author , Bastien Gondran-TellierBastien Gondran-Tellier More articles by this author , Xavier MatillonXavier Matillon More articles by this author , Zine-Eddine KheneZine-Eddine Khene More articles by this author , and Benjamin PradereBenjamin Pradere More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002044.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The use of Doppler ultrasonography (US) for patients with suspected testicular torsion (TT) is highly controversial and remains debated, as it can delay surgery and its performance may vary. Our objective was to assess the role, impact, safety and performance of Doppler US in the management of patients with suspected TT before undergoing scrotal exploration. METHODS: The TORSAFUF cohort retrospectively included patients older than 12 years who underwent surgery for suspected TT in 14 academic hospitals over 15 years. Perioperative data and surgical and Doppler US reports were collected. Clinical factors influencing Doppler US realization were evidenced through multivariate logistic regression. The orchidectomy rate and delay to surgery were compared based on Doppler US realization with a 1-to-1 propensity score to assess imaging safety. Within the group that had preoperative imaging, Doppler US performance was evaluated using a contingency table. RESULTS: Overall, 2922 patients were included in this study. Among them, 956 (32.7%) underwent Doppler US prior to surgery. Doppler US was more likely to be performed in older patients, those who experienced progressive onset of pain, and patients who presented at the emergency department more than 6 hours from the beginning of scrotal symptoms (OR [95% CI]: 1.1 [1.1-1.2], 1.5 [1.1-2], and 2.3 [1.9-2.8]). Realization of Doppler US was not significantly associated with orchidectomy after propensity score matching, whereas the delay to surgery was 1 hour longer if performed. Doppler US demonstrated a strong sensitivity of 85.2% (95% CI [82.1-88.3]) and a specificity of 52.7% (95% CI [48.8-56.6]). The performance was better for younger patients and for those with an onset of pain >6 hours. CONCLUSIONS: In this large retrospective study, Doppler US prior to surgery was safe, feasible and useful in selected cases, but it should not delay or replace surgery in cases with strong clinical suspicion. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e632-e632 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ugo Pinar More articles by this author Igor Duquesne More articles by this author François Lannes More articles by this author Florian Bardet More articles by this author Kévin Kaulanjan More articles by this author Clément Michiels More articles by this author Emilien Seizilles de Mazancourt More articles by this author Maxime Vallee More articles by this author Margaux Felber More articles by this author Lucas Freton More articles by this author William Berchiche More articles by this author Caroline Plassais More articles by this author Bastien Gondran-Tellier More articles by this author Xavier Matillon More articles by this author Zine-Eddine Khene More articles by this author Benjamin Pradere More articles by this author Expand All Advertisement Loading ...