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 language | English (US) |
|---|---|
| Pages (from-to) | 2009-2013 |
| Number of pages | 5 |
| Journal | Journal of Urology |
| Volume | 186 |
| Issue number | 5 |
| DOIs | |
| State | Published - Nov 1 2011 |
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Keywords
- epidemiology
- socioeconomic factors
- spermatic cord torsion
ASJC Scopus subject areas
- Urology
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Pediatric Testicular Torsion Epidemiology Using a National Database : Incidence, Risk of Orchiectomy and Possible Measures Toward Improving the Quality of Care. / Zhao, Lee C.; Lautz, Timothy B; Meeks, Joshua J; Maizels, Max.
In: Journal of Urology, Vol. 186, No. 5, 01.11.2011, p. 2009-2013.Research output: Contribution to journal › Article
TY - JOUR
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.
KW - epidemiology
KW - socioeconomic factors
KW - spermatic cord torsion
UR - http://www.scopus.com/inward/record.url?scp=80054000743&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80054000743&partnerID=8YFLogxK
U2 - 10.1016/j.juro.2011.07.024
DO - 10.1016/j.juro.2011.07.024
M3 - Article
VL - 186
SP - 2009
EP - 2013
JO - Journal of Urology
JF - Journal of Urology
SN - 0022-5347
IS - 5
ER -