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Can Ultrasound Reduce the Rate of Negative Testicular Exploration in Suspicious Acute Scrotum; A 5-Year Experience in A District Hospital

Author(s): Ahmed Gendia, S. Tariq Cheema, Yousaf Tanveer

Objective: To retrospectively outline findings of testicular exploration in patients with suspicious acute scrotum and to compare the outcomes between exploration with and without US as a preoperative diagnostic tool.

Methods: A retrospective analysis of patients underwent scrotal exploration from Jan2014 till Dec 2018 in our hospital was conducted. The data were divided into exploration with preoperative ultrasound (US group) and exploration without preoperative US (non-US group).

Results: 47 patients (mean age 14-years) were explored during the 5-year period. The most common finding was torsion Cyst of Morgagni (34%, 16/47). True torsion was found in 27.6% (13/47) with 3 unsalvageable testes. Torsion rates were higher in patients who underwent US (7/14, 50%) than exploration without US (6/33, 18.1%). Time delay between two groups showed no statistical difference (p-value >.05). Also, US showed 70% sensitivity and 100% Specificity regarding torsion testis.

Conclusion: Based on our numbers, negative exploration can be reduced with the help of US as a diagnostic tool for torsion. However, until further studies with larger populations and definitive pathway regarding ultrasound are commenced, we recommend urgent exploration as the standard intervention in dealing with suspicious acute scrotum.

 

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