EN
TÜRKÇE
Oral Presentation - 29
Elective orchidopexy after manual detorsion in pediatric spermatic cord torsion: an 8-year retrospective study
António Moreira, Diogo Cardoso, Rafael Bernardo, Elizabete Vieira
Hospital de Santa Maria, Lisbon
European pediatric urology guidelines recommend immediate bilateral orchidopexy after successful manual detorsion (MD) of testicular torsion. In our tertiary center, elective orchidopexy is performed after successful detorsion rather than immediate surgery. This study aimed to evaluate the safety of delayed orchidopexy following MD.
A retrospective study was conducted over eight years (2017–2024), including pediatric patients with testicular torsion. Group A included patients who underwent successful MD (confirmed by pain relief, physical exam normalization, and Doppler ultrasound) followed by elective orchidopexy. Group B included patients undergoing urgent orchidopexy after diagnosis. Cases requiring orchiectomy were excluded. Variables analyzed included demographic data, torsion side, symptoms duration, surgical approach, operative time, follow-up duration and results. For Group A, time to surgery were also evaluated.
Of 267 cases, 86 were included in Group A and 89 in Group B. No significant differences were observed in age (p=0.069), torsion side (p=0.573), or symptoms duration (p=0.240). The median interval between MD and elective orchidopexy was 25 days (IQR 15–49; range 3–295). One retorsion case occurred in Group A, 208 days after MD, requiring urgent surgery. No testicular loss occurred in Group A. Postoperative complications were higher and more severe in Group B, though not statistically significant (p=0.168 for frequency; p=0.150 for severity). During follow-up no difference in testicular symmetry was found (p=0.010).
Delayed orchidopexy after successful MD appears safe, with no testicular loss cases and minimal retorsion risk when surgery performed within four weeks. Although statistical significance was not reached, complication rates tended to be lower and less severe in the elective surgery group, possibly due to operating outside of the acute inflammatory phase. These findings support the non-inferiority of this approach, though multicenter prospective studies are needed to confirm its safety.