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Testicular torsion in Ireland: a 10-year analysis of incidence and risk of orchidectomy

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Abstract

Background

The estimated incidence of testicular torsion (TT) is 4 per 100,000 males under 25 years [1]. Age, region and health insurance status have been associated with a higher risk of orchidectomy following TT [2].

Aims

This study aimed to establish incidence rates for TT in Ireland for the first time. Sociodemographic characteristics were analysed to assess risk factors for undergoing orchidectomy.

Methods

A retrospective analysis of a national database, Hospital In-Patient Enquiry (HIPE), was carried out. Cases of TT treated between 2009 and 2018 were identified. Incidence and age-specific rates were calculated in conjunction with census data. Descriptive statistics, non-parametric tests and logistic regression were used to evaluate risk factors for orchidectomy.

Results

Between 2009 and 2018, 1746 males under 25 years underwent scrotal exploration for TT. The crude incidence was 21.76 per 100,000 population. The age-standardised rate rose from 16.85 per 100,000 in 2009 to 26.31 per 100,000 in 2018. TT was most common in the 10–14 years age-group (n = 766, 43%) with a normal distribution across age-groups. TT most commonly occurred in spring (27.55%, 95% CI 25.46–29.71%), and was least common in summer (21.65%, 95% CI 19.46–23.36%, p < 0.01). Age, lack of private insurance, province of residence and transfer from another hospital were associated with orchidectomy.

Conclusions

The incidence of TT appears to be higher in Ireland than elsewhere. Epidemiological data for TT in Ireland will help inform health policy and clinical guidelines, facilitate comparison with other jurisdictions and improve public awareness. Further research is needed to identify modifiable risk factors that predict treatment outcomes.

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Data availability

Data and codebook are available upon request.

Notes

  1. Defined as non-elective patients who were admitted to an inpatient bed, irrespective of LOS.

References

  1. Zhao LC, Lautz TB, Meeks JJ, Maizels M (2011) Pediatric testicular torsion epidemiology using a national database: incidence, risk of orchiectomy and possible measures toward improving the quality of care. J Urol 186:2009–2013. https://doi.org/10.1016/j.juro.2011.07.024

    Article  PubMed  Google Scholar 

  2. Cost NG, Bush NC, Barber TD et al (2011) Pediatric testicular torsion: demographics of national orchiopexy versus orchiectomy rates. In: Journal of Urology. pp 2459–2463

  3. Huang W-Y, Chen Y-F, Chang H-C et al (2013) The incidence rate and characteristics in patients with testicular torsion: a nationwide, population-based study. Acta Paediatr 102:e363–e367. https://doi.org/10.1111/apa.12275

    Article  PubMed  Google Scholar 

  4. Mansbach JM, Forbes P, Peters C (2005) Testicular torsion and risk factors for orchiectomy. Arch Pediatr Adolesc Med 159:1167–1171. https://doi.org/10.1001/archpedi.159.12.1167

    Article  PubMed  Google Scholar 

  5. Visser AJ, Heyns CF (2003) Testicular function after torsion of the spermatic cord. BJU Int 92:200–203. https://doi.org/10.1046/j.1464-410x.2003.04307.x

    Article  CAS  PubMed  Google Scholar 

  6. Health Insurance Authority (2018) 2018 Annual Report & Accounts

  7. Organisation for Economic Co-operation and Development (OECD) & European Observatory on Health Systems and Policies, (2019) Ireland: Country Health Profile 2019. European Commission, Brussels

    Google Scholar 

  8. Mueller M, Socha-Dietrich K (2020) Reassessing private practice in public hospitals in Ireland

  9. Central Statistics Office (2020) Databases. https://www.cso.ie/en/databases/. Accessed 29 Dec 2020

  10. Ahmad OB, Boschi-Pinto C, Lopez Christopher AD et al (2001) Age standardization of rates: a new WHO standard

  11. Healthcare Pricing Office (2019) Activity in acute public hospitals in Ireland - 2018 Annual Report. Dublin

  12. Healthcare Pricing Office (2020) Hospital in-patient enquiry scheme (HIPE). http://www.hpo.ie/. Accessed 20 Jun 2020

  13. Lee SM, Huh J-SS, Baek M et al (2014) A nationwide epidemiological study of testicular torsion in Korea. Journal of Korean medical science 29:1684–1687. https://doi.org/10.3346/jkms.2014.29.12.1684

  14. StataCorp (2019) Stata Statistical Software: Release 16

  15. Anderson JB, Williamson RC (1988) Testicular torsion in Bristol: a 25-year review. Br J Surg 75:988–992. https://doi.org/10.1002/bjs.1800751015

    Article  CAS  PubMed  Google Scholar 

  16. Raine JE (2011) An analysis of successful litigation claims in children in England. Arch Dis Child 96:838–840. https://doi.org/10.1136/adc.2011.212555

    Article  PubMed  Google Scholar 

  17. Selbst SM, Friedman MJ, Singh SB (2005) Epidemiology and etiology of malpractice lawsuits involving children in US emergency departments and urgent care centers. Pediatr Emerg Care 21:165–169

    Article  Google Scholar 

  18. Medical Protection Society (2015) Challenging the cost of clinical negligence: the case for reform. Dublin

  19. Korkes F, dos Cabral PR, A, Alves CDM, et al (2012) Testicular torsion and weather conditions: analysis of 21,289 cases in Brazil. International braz j urol : official journal of the Brazilian Society of Urology 38:222–229

    Article  Google Scholar 

  20. Shukla RB, Kelly DG, Daly L, Guiney EJ (1982) Association of cold weather with testicular torsion. Br Med J (Clin Res Ed) 285:1459–1460. https://doi.org/10.1136/bmj.285.6353.1459

    Article  CAS  Google Scholar 

  21. Srinivasan AK, Freyle J, Gitlin JS, Palmer LS (2007) Climatic conditions and the risk of testicular torsion in adolescent males. The Journal of urology 178:2585–8; discussion 2588. https://doi.org/10.1016/j.juro.2007.08.049

  22. MacDonald C, Kronfli R, Carachi R, O’Toole S (2018) A systematic review and meta-analysis revealing realistic outcomes following paediatric torsion of testes. J Pediatr Urol 14:503–509

    Article  CAS  Google Scholar 

  23. Peeraully R, Jancauskaite M, Dawes S et al (2019) Does the source of referral affect outcomes for paediatric testicular torsion? Ann R Coll Surg Engl 101:411–414. https://doi.org/10.1308/rcsann.2019.0045

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Royal College of Surgeons of England (2016) Commissioning guide: management of paediatric torsion. London

  25. Bayne AP, Madden-Fuentes RJ, Jones EA et al (2010) Factors associated with delayed treatment of acute testicular torsion-do demographics or interhospital transfer matter? J Urol 184:1743–1747. https://doi.org/10.1016/j.juro.2010.03.073

    Article  PubMed  Google Scholar 

  26. Walsh B, Silles M, O’Neill C (2012) The role of private medical insurance in socio-economic inequalities in cancer screening uptake in ireland. Health Economics (United Kingdom) 21:1250–1256. https://doi.org/10.1002/hec.1784

    Article  Google Scholar 

  27. Ubee SS, Hopkinson V, Srirangam SJ (2014) Parental perception of acute scrotal pain in children. Ann R Coll Surg Engl 96:618–620. https://doi.org/10.1308/003588414X14055925058878

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Yap LC, Keenan R, Khan J et al (2018) Parental awareness of testicular torsion amongst Irish parents. World J Urol 36:1485–1488. https://doi.org/10.1007/s00345-018-2269-8

    Article  PubMed  Google Scholar 

  29. Green C, Stubbs V, Green JS (2020) Public health education initiatives for testicular torsion. Trends in Urology & Men’s Health 11:14–16. https://doi.org/10.1002/tre.775

    Article  Google Scholar 

  30. Nason GJ, Tareen F, McLoughlin D et al (2013) Scrotal exploration for acute scrotal pain: a 10-year experience in two tertiary referral paediatric units. Scandinavian journal of urology 47:418–422. https://doi.org/10.3109/00365599.2012.752403

    Article  PubMed  Google Scholar 

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Acknowledgements

Many thanks to Prof. Jan Van Der Meulen and Dr. Annelieke Driessen at LSHTM, who helped formulate the research design. A special thanks to the staff at University College Dublin School of Public Health who advised on statistical analyses.

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Authors and Affiliations

  1. Transplant Urology and Nephrology Directorate, Beaumont Hospital, Beaumont, Dublin 9, Ireland

    Diarmuid D. Sugrue, Eabhann O’Connor & Niall Davis

  2. London School of Hygiene and Tropical Medicine, Keppel Street, Bloomsbury, London, UK

    Diarmuid D. Sugrue

Authors
  1. Diarmuid D. Sugrue
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  2. Eabhann O’Connor
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Correspondence to Diarmuid D. Sugrue.

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Ethical approval was granted by London School of Hygiene and Tropical Medicine Research Ethics Committee (reference number: 22007).

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Sugrue, D.D., O’Connor, E. & Davis, N. Testicular torsion in Ireland: a 10-year analysis of incidence and risk of orchidectomy. Ir J Med Sci 191, 2267–2274 (2022). https://doi.org/10.1007/s11845-021-02816-8

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