📃 Paper Title: A Systematic Review of Testicle Survival Time After a Torsion Event
🧍 Author: Mellick
🕒 Year: 2019
📚 Journal: Paediatric Emergency Care
🌎 Country: USA
ㅤContext to the study:
Can you tell me about the evidence around testicular viability after a torsion event?
ㅤ✅ Take-home message of study:
This systematic review provides useful data on testicular viability after different time intervals from a testicular torsion event. Testicular salvage is greatest when presentation and treatment is within 0 to 6 hours of symptom onset (96%). Beyond this, survival decreases with increasing time from presentation, however a proportion (10%) remains viable after >48 hours of symptoms.
ㅤ Systematic review including 30 case series with 2,116 patients
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Study participants:
Male patients from the age of 6 months.
Inclusion criteria: all English, available full text articles that provided observational data of TT patients (6 months through adulthood) from retrospective, prospective, chart reviews, systematic reviews, and case series.
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Key study outcomes:
Testis survival according to time from onset of the torsion event.
0-6 hours = 96% Survival
7-12 hours = 78% Survival
13-24 hours = 49% Survival
25-48 hours = 29% Survival
48 hours = 10% Survival
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Study Limitations:
It is likely that both duration of symptoms and degree of torsion (180° v 720°) affect salvage rate, but only the former is considered in this review. Rate of testicular atrophy following prolonged periods of ischemia were not reported, and where cases of testicular salvage >48 hours were identified it was not reported if intermittent torsion had been apparent. A systematic review of retrospective case series limited to English language reports will result in biases in the included studies and therefore the results should be considered in that context.
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