title: Cold weather is a predisposing factor for testicular torsion in a tropical country. A retrospective study.
abstract: OBJECTIVE
  Testicular torsion is a medical and urological emergency because it can lead to loss of the organ. The theory of seasonal testicular torsion occurrence is based on studies from institutions located in cold and temperate regions. The objective here was to determine whether cold weather is associated with higher incidence of testicular torsion in a tropical country, such as Brazil.
  
  
  METHODS
  Retrospective study, conducted in a tertiary and teaching hospital.
  
  
  METHODS
  Patients with acute testicular torsion confirmed by surgery between April 2006 and March 2011 were studied. Information on weather conditions at the time of symptom onset was collected.
  
  
  RESULTS
  A total of 64 testicular torsion cases were identified. The months with the highest incidences of testicular torsion were June (16%), July (19%) and August (11%), which had the lowest mean temperatures, of 17.6 °C, 16.4 °C and 18.2 °C, respectively. Eleven percent of cases occurred during spring (October to December), 16% occurred in summer (January to March), 34% occurred in fall (April to June) and 39% occurred in winter (July to September). There was a significant association between the incidence of testicular torsion and the season (fall and winter), P < 0.001.
  
  
  CONCLUSIONS
  Testicular torsion follows a seasonal association even in a tropical country, and is more frequent in the colder months of the year, namely fall and winter, when almost three-quarters of the cases occurred. These observations add further evidence that cold weather has an etiologic role in testicular torsion occurrence.
authors.affiliation: Department of Urology, Hospital Santa Marcelina, São Paulo, São Paulo, Brazil.
authors.forename: Daniel de Oliveira
authors.initials: Dde O
authors.lastname: Gomes
authors.affiliation: Department of Urology, Hospital Santa Marcelina, São Paulo, São Paulo, Brazil.
authors.forename: Rafael Rocha
authors.initials: RR
authors.lastname: Vidal
authors.affiliation: Department of Urology, Hospital Santa Marcelina, São Paulo, São Paulo, Brazil.
authors.forename: Bruno Figueiredo
authors.initials: BF
authors.lastname: Foeppel
authors.affiliation: Department of Pediatric Surgery, Hospital Santa Marcelina, São Paulo, São Paulo, Brazil.
authors.forename: Danilo Fiorindo
authors.initials: DF
authors.lastname: Faria
authors.affiliation: Department of Urology, Hospital Santa Marcelina, São Paulo, São Paulo, Brazil.
authors.forename: Minori
authors.initials: M
authors.lastname: Saito
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003080:Cold Temperature / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012621:Seasons; D013086:Spermatic Cord Torsion / Q000453:epidemiology / Q000209:etiology*; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D013997:Time Factors; D014329:Tropical Climate; D055815:Young Adult