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Validation of the Testicular Workup for Ischemia and Suspected Torsion (TWIST) Score in the Diagnosis of Testicular Torsion in Children With Acute Scrotum

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Abstract

Objective

To validate the Testicular Workup for Ischemia and Suspected Torsion (TWIST) score for the evaluation of children presenting with acute scrotum.

Methods

This prospective study calculated TWIST score in patients of acute scrotum admitted to a pediatric surgery unit. The scoring system consisted of testicular swelling (2 points), hard testicle (2), absent cremasteric reflex (1), nausea/vomiting (1) and high-riding testis (1). All the patients were examined by a pediatric surgeon.

Results

Among 96 children with acute scrotum, 68 (70.8%) patients had testicular torsion. In the testicular torsion group, the mean (SD) TWIST score was 5.7 (1.2) and in no torsion group, it was 1.46 (0.67). In the testicular torsion group, the number of patients with low, intermediate, and high risk was 0, 13, and 55, respectively and in without testicular torsion these were 21, 7, and 0, respectively.

Conclusions

TWIST score has high predictive value for testicular torsion, and can be used for clinical diagnosis of testicular torsion.

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Authors and Affiliations

  1. Pediatric Surgery Unit, Ashish Hospital and Research Centre, Jabalpur, Madhya Pradesh, India

    Pradyumna Pan

Authors
  1. Pradyumna Pan
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Contributions

PP: developed the concept and designed the study, collected and analyzed the data, drafted the manuscript.

Corresponding author

Correspondence to Pradyumna Pan.

Ethics declarations

Institutional Ethics Committee; No. 17/ASH/Study 03/2017, dated January 01, 2017.

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Competing interest

None stated.

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Pan, P. Validation of the Testicular Workup for Ischemia and Suspected Torsion (TWIST) Score in the Diagnosis of Testicular Torsion in Children With Acute Scrotum. Indian Pediatr 57, 926–928 (2020). https://doi.org/10.1007/s13312-020-1992-6

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  • DOI: https://doi.org/10.1007/s13312-020-1992-6

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