Pediatric Testicular Torsion Epidemiology Using a National Database

Incidence, Risk of Orchiectomy and Possible Measures Toward Improving the Quality of Care

Lee C. Zhao*, Timothy B Lautz, Joshua J Meeks, Max Maizels

*Corresponding author for this work

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

Purpose: Testicular torsion causes considerable morbidity in the pediatric population but the societal burden is poorly quantified. We determined the modern incidence of testicular torsion as well as the current rates of orchiectomy and attempted testicular salvage, and identified the risk factors for testicular loss. Materials and Methods: A cohort analysis was performed of 2,443 boys (age 1 month to less than 18 years) and 152 newborns who underwent surgery for testicular torsion in the 2000, 2003 and 2006 Healthcare Cost and Utilization Project Kids' Inpatient Database. Patient and hospital characteristics predictive of orchiectomy vs attempted testicular salvage were analyzed. Results: There was a bimodal distribution of testicular torsion with peaks in the first year of life and in early adolescence. The overall mean age ± SD at presentation was 10.6 ± 5.8 years. The estimated yearly incidence of testicular torsion for males younger than 18 years old was 3.8 per 100,000. Orchiectomy was performed in 41.9% of boys undergoing surgery for torsion. The adjusted odds ratio for orchiectomy was highest for children in the youngest age quartile (younger than 10 years old, OR 1.58, 95% CI 1.252.00). Additional independent predictors of orchiectomy included Medicaid insurance (OR 1.39, 95% CI 1.141.69), black race (OR 1.33, 95% CI 1.041.71), nonemergency room admission source (OR 1.97, 95% CI 1.602.42) and surgery at a children's hospital or unit (OR 1.64, 95% CI 1.361.98). Conclusions: Testicular torsion is uncommon but the rate of orchiectomy is high, especially in the youngest patients.

Original languageEnglish (US)
Pages (from-to)2009-2013
Number of pages5
JournalJournal of Urology
Volume186
Issue number5
DOIs
StatePublished - Nov 1 2011

Fingerprint

Spermatic Cord Torsion
Orchiectomy
Quality of Health Care
Epidemiology
Databases
Pediatrics
Incidence
Hospital Units
Medicaid
Insurance
Health Care Costs
Inpatients
Cohort Studies
Odds Ratio
Newborn Infant
Morbidity
Population

Keywords

  • epidemiology
  • socioeconomic factors
  • spermatic cord torsion

ASJC Scopus subject areas

  • Urology

Cite this

@article{74c4f4b347704c489c99ddae04e0394e,
title = "Pediatric Testicular Torsion Epidemiology Using a National Database: Incidence, Risk of Orchiectomy and Possible Measures Toward Improving the Quality of Care",
abstract = "Purpose: Testicular torsion causes considerable morbidity in the pediatric population but the societal burden is poorly quantified. We determined the modern incidence of testicular torsion as well as the current rates of orchiectomy and attempted testicular salvage, and identified the risk factors for testicular loss. Materials and Methods: A cohort analysis was performed of 2,443 boys (age 1 month to less than 18 years) and 152 newborns who underwent surgery for testicular torsion in the 2000, 2003 and 2006 Healthcare Cost and Utilization Project Kids' Inpatient Database. Patient and hospital characteristics predictive of orchiectomy vs attempted testicular salvage were analyzed. Results: There was a bimodal distribution of testicular torsion with peaks in the first year of life and in early adolescence. The overall mean age ± SD at presentation was 10.6 ± 5.8 years. The estimated yearly incidence of testicular torsion for males younger than 18 years old was 3.8 per 100,000. Orchiectomy was performed in 41.9{\%} of boys undergoing surgery for torsion. The adjusted odds ratio for orchiectomy was highest for children in the youngest age quartile (younger than 10 years old, OR 1.58, 95{\%} CI 1.252.00). Additional independent predictors of orchiectomy included Medicaid insurance (OR 1.39, 95{\%} CI 1.141.69), black race (OR 1.33, 95{\%} CI 1.041.71), nonemergency room admission source (OR 1.97, 95{\%} CI 1.602.42) and surgery at a children's hospital or unit (OR 1.64, 95{\%} CI 1.361.98). Conclusions: Testicular torsion is uncommon but the rate of orchiectomy is high, especially in the youngest patients.",
keywords = "epidemiology, socioeconomic factors, spermatic cord torsion",
author = "Zhao, {Lee C.} and Lautz, {Timothy B} and Meeks, {Joshua J} and Max Maizels",
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language = "English (US)",
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T1 - Pediatric Testicular Torsion Epidemiology Using a National Database

T2 - Incidence, Risk of Orchiectomy and Possible Measures Toward Improving the Quality of Care

AU - Zhao, Lee C.

AU - Lautz, Timothy B

AU - Meeks, Joshua J

AU - Maizels, Max

PY - 2011/11/1

Y1 - 2011/11/1

N2 - Purpose: Testicular torsion causes considerable morbidity in the pediatric population but the societal burden is poorly quantified. We determined the modern incidence of testicular torsion as well as the current rates of orchiectomy and attempted testicular salvage, and identified the risk factors for testicular loss. Materials and Methods: A cohort analysis was performed of 2,443 boys (age 1 month to less than 18 years) and 152 newborns who underwent surgery for testicular torsion in the 2000, 2003 and 2006 Healthcare Cost and Utilization Project Kids' Inpatient Database. Patient and hospital characteristics predictive of orchiectomy vs attempted testicular salvage were analyzed. Results: There was a bimodal distribution of testicular torsion with peaks in the first year of life and in early adolescence. The overall mean age ± SD at presentation was 10.6 ± 5.8 years. The estimated yearly incidence of testicular torsion for males younger than 18 years old was 3.8 per 100,000. Orchiectomy was performed in 41.9% of boys undergoing surgery for torsion. The adjusted odds ratio for orchiectomy was highest for children in the youngest age quartile (younger than 10 years old, OR 1.58, 95% CI 1.252.00). Additional independent predictors of orchiectomy included Medicaid insurance (OR 1.39, 95% CI 1.141.69), black race (OR 1.33, 95% CI 1.041.71), nonemergency room admission source (OR 1.97, 95% CI 1.602.42) and surgery at a children's hospital or unit (OR 1.64, 95% CI 1.361.98). Conclusions: Testicular torsion is uncommon but the rate of orchiectomy is high, especially in the youngest patients.

AB - Purpose: Testicular torsion causes considerable morbidity in the pediatric population but the societal burden is poorly quantified. We determined the modern incidence of testicular torsion as well as the current rates of orchiectomy and attempted testicular salvage, and identified the risk factors for testicular loss. Materials and Methods: A cohort analysis was performed of 2,443 boys (age 1 month to less than 18 years) and 152 newborns who underwent surgery for testicular torsion in the 2000, 2003 and 2006 Healthcare Cost and Utilization Project Kids' Inpatient Database. Patient and hospital characteristics predictive of orchiectomy vs attempted testicular salvage were analyzed. Results: There was a bimodal distribution of testicular torsion with peaks in the first year of life and in early adolescence. The overall mean age ± SD at presentation was 10.6 ± 5.8 years. The estimated yearly incidence of testicular torsion for males younger than 18 years old was 3.8 per 100,000. Orchiectomy was performed in 41.9% of boys undergoing surgery for torsion. The adjusted odds ratio for orchiectomy was highest for children in the youngest age quartile (younger than 10 years old, OR 1.58, 95% CI 1.252.00). Additional independent predictors of orchiectomy included Medicaid insurance (OR 1.39, 95% CI 1.141.69), black race (OR 1.33, 95% CI 1.041.71), nonemergency room admission source (OR 1.97, 95% CI 1.602.42) and surgery at a children's hospital or unit (OR 1.64, 95% CI 1.361.98). Conclusions: Testicular torsion is uncommon but the rate of orchiectomy is high, especially in the youngest patients.

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