title: Seasonal preponderance in testicular torsion: is it a myth?
abstract: OBJECTIVE
  In this study, we aimed to investigate the relation of testicular torsion and weather conditions, and to report results from Turkey, a country located between temperate and sub-tropical climate zones.
  
  
  METHODS
  A total of 56 patients that had surgery with the diagnosis of testicular torsion in Ankara Education and Research Hospital Urology Clinic between 2005 and 2014 were included in the study. Age of the patient, side of torsion, date and time at onset of pain, scrotal exploration time, ischemia duration, degree of cord torsion, the surgical procedure performed, and scrotal Doppler ultrasound (USG) findings at the time of diagnosis and 1 month after surgery were retrospectively analyzed. The web archives of Turkish Republic Meteorology General Directorate was used to determine the seasonal and mean temperatures at the time of diagnosis. The data were analyzed with SPSS v. 16 statistical package program using Chi-square, Mann- Whitney U and Wilcoxon tests.
  
  
  RESULTS
  The mean age of 56 males included in the study was 18.88 ± 0.73 years. Right testicular torsion was seen in 23, and left testicular torsion was seen in 33 patients. Testicular arterial flow was absent in 37, arterial flow was moderately decreased in 12, and significantly decreased in 7 patients on Doppler USG. Detorsion procedure was performed in 46 patients while 10 patients had orchiectomy. Nine patients were admitted in summer, 14 in fall, 15 in winter, and 18 in spring. The mean air temperature at the time of admittance was 9.31 ± 1.05 °C. The prevalence of testicular torsion was not found different among the seasons (p=0.39). The analysis of air temperature at the time of admittance of the patients revealed that it was below 15 °C in 40 patients while it was above 15 °C in 16 patients, with a significant difference in between (p=0.002).
  
  
  CONCLUSIONS
  The prevalence of testicular torsion did not change in relation with the seasons. However, it was determined that its prevalence was directly proportional to the air temperature, and increased particularly below 15 °C.
authors.affiliation: Department of Urology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Karakan
authors.affiliation: Kafkas University Faculty of Medicine, Department of Urology, Kars, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Bagcioglu
authors.affiliation: Department of Urology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Özcan
authors.affiliation: Ankara University, School of Medicine, Department of Pediatric Urology, Ankara, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Telli
authors.affiliation: Department of Urology, Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Turgut
authors.affiliation: Department of Urology, Izmir Atatürk Education and Research Hospital, Izmir, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Özkan
authors.affiliation: Ondokuz Mayis University, School of Medicine, Department of Pediatric Urology, Samsun, Turkey.
authors.forename: Cancon
authors.initials: C
authors.lastname: Germiyanoglu
mesh_terms: D000293:Adolescent; D003080:Cold Temperature; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012621:Seasons; D013086:Spermatic Cord Torsion / Q000453:epidemiology*; D014421:Turkey