title: Acute and intermittent testicular torsion: Analysis of presentation, management, and outcome in South East, Nigeria.
abstract: BACKGROUND
  Testicular torsion compromises the blood supply to the testes and may result in testicular loss or damage if not dealt with promptly. It can occur either as acute testicular torsion (ATT) or intermittent testicular torsion (ITT). This study examines the presentation, management, and outcome of adult testicular torsion.
  
  
  METHODS
  During the period January 1999 and December 2009, 34 out of 59 patients treated for testicular torsion, who had complete records, were evaluated. Operating theater and urology ward admission registers were used to identify patients.
  
  
  RESULTS
  Age range was 16-50 years. Of the 34 patients, 11 (32.4%) were between 26 and 30 years old, while 16 (47.1%) were between 16 and 25 years old. Mean age was 27 years. Scrotal pain of varying severity was noted in all patients; there was associated vomiting in 21% of cases and abdominal pain in 38% of cases. Clinical diagnosis was ATT in 12 (35.3%) patients and ITT in 22 (64.7%) patients. In the ATT group, only one patient (8.3%) presented within 6 h of onset of symptoms. In the ITT group, 3 patients (13.6%) presented within 1 month of onset of symptoms while 7 (31.8%) of patients presented between 1 and 6 months after the onset of symptoms. Testicular salvage rate was 58.3% for ATT. Surgical intervention occurred within 3 h in the ATT group in 7 patients (58.3%) and in 5 patients (41.7%) within 3-6 h of onset of symptoms. In the patients with ITT, 12 patients (54.5%) were operated upon within 1 month of presentation. Preoperative external manual detorsion was performed in 1 patient.
  
  
  CONCLUSIONS
  Late presentation was observed, especially in the intermittent variety. Delay occurred both at pre- and intra-hospital phases. Testicular salvage rate may be improved by physician/health worker and community enlightenment. Adoption of local anesthetic may reduce intrahospital delay.
authors.affiliation: Department of Surgery, Faculty of Medical Sciences University of Nigeria, Enugu, Enugu State; Department of Surgery, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria.
authors.forename: F O
authors.initials: FO
authors.lastname: Ugwumba
authors.forename: A D
authors.initials: AD
authors.lastname: Okoh
authors.forename: K N
authors.initials: KN
authors.lastname: Echetabu
mesh_terms: D015746:Abdominal Pain / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D009919:Orchiectomy; D017699:Pelvic Pain; D012720:Severity of Illness Index; D013086:Spermatic Cord Torsion / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D013737:Testis / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult