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Improving parentsí awareness of testicular torsion to decrease delays in care for boys with acute testicular pain
Benjamin Abelson, MD, Mark C. Adams, MD, John W. Brock, III, MD, John C. Pope, IV, MD, Stacy T. Tanaka, MD, Douglass B. Clayton, MD, John C. Thomas, MD, Abby S. Taylor, MD.
Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.

BACKGROUND: Testicular torsion is a surgical emergency that is managed either with detorsion and orchidopexy if the testicle is salvageable, or orchiectomy if the testicle is unsalvageable. Avoiding orchiectomy is dependent on prompt evaluation, diagnosis and management. Significant efforts have been made to streamline the process from arrival at the hospital to diagnosis and definitive operative management. However, the most significant time delay occurs prior to arrival at the hospital. We aimed to gauge general awareness regarding testicular torsion and to develop an educational video to address the lack of awareness of testicular torsion. METHODS:We developed a survey intended to ask parents about their awareness of testicular torsion, and to understand how they would react if their child developed acute scrotal pain. After IRB approval, the survey was distributed to participants using ResearchMatch, and any parent or guardian with a male child of any age was invited to complete the survey. After completing the survey, participants viewed a 5 minute animated video about testicular torsion, and answered several follow-up questions. RESULTS: 643 parents or guardians of boys completed the survey. 524/640 participants (82%) had children under the age of 15. 524 participants (82%) were White, and 46 (7.2%) were Black. 75% of participants were female, 46.3% had completed a graduate degree or higher, and 74.7% were privately insured. 30.7% of participants worked in the healthcare industry. Most parents (58.5%) report they would call their pediatrician if their son complained of acute scrotal pain as a child, though only 21.8% report they would go straight to the emergency room. 126 (19.7%) of respondents report they would wait to see if the pain would go away, and of these parents, 40% report they would wait longer than 3 hours. Only 55.7% of parents have heard of testicular torsion, and an overwhelming majority (86%) report that they have never discussed with their son what to do if he develops scrotal pain. 91.7% of parents report the video taught them something about testicular pain, and after viewing the video, only 15/624 participants (2.4%) report that they would still wait to see if acute onset scrotal pain resolved on its own. CONCLUSIONS: Half of parents/guardians of boys have never heard of testicular torsion, and many parents report that if their child developed acute scrotal pain, they would wait for it to go away before considering calling a physician or going to the emergency room. Furthermore, we hypothesize that this study overestimates the general publicís awareness of testicular torsion, given that it represents a well-educated subset of the population. Viewing a short, animated, educational video was found to be beneficial to parents, and led to a change in survey response regarding what they would do if their child developed testicular pain.


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