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Testicular Torsion: What a Difference Knowledge Makes
Sara Vidovic, MD, Chrisla T. Key, DNP, FNP, NP-C, A. Jill Travis, MSN, FNP, Nicholas J. Nordin, MD, Amr Mahran, MD, Dana W. Giel, MD.
University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, TN, USA.

BACKGROUND: Testicular torsion (TT) is a frequently encountered diagnosis that has serious implications for patients. It is well understood that management is time sensitive, and delay for any reason carries significant consequences including testicular atrophy or loss. Because patients and parents are the primary drivers in initiating care for TT, their timely recognition of the importance of testicular pain (TP) is critical. We hypothesize that many patients and parents are not educated about TT, and their lack of knowledge can delay treatment which could adversely affect outcomes.
METHODS: An IRB-approved study was performed from October 2020 through May 2022. Boys 10 years and older, along with their parents/legal guardians, who were attending urology clinic for any diagnosis other than TT, were identified and surveyed regarding their reactions and approaches to TP. Surveys were collected, after which an educational handout about TT was provided, followed by a similar post-education survey. Pre/post responses were recorded and compared. Incomplete surveys were excluded.
RESULTS: 179 patients and 191 parents had completed surveys. Prior to education, only 19% of patients and 41% of parents reported familiarity with TT. Boys reported feeling less embarrassed to tell a doctor about TP compared with telling a parent, although embarrassment scores decreased for both following education. Prior to education, 39% of boys reported that they would wait one day or longer to report TP, whereas following education, 76.4% responded that they would report TP within the first 2 hours of onset (p=0.002). Prior to education, only 49.2% of parents reported that they would call their physician urgently or seek emergent evaluation if their son had TP; after education, 86.4% of parents reported that they would seek urgent or emergent evaluation (p<0.001).
CONCLUSIONS: Knowledge about TT and implications of TP have significant impact on how patients and parents would respond to TP. This in turn can positively influence outcomes for management of TT. Greater emphasis needs to be placed on educating boys and their parents about TT and its consequences, and this would likely result in lower rates of orchiectomy related to delayed presentation in boys with TP.


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