WOFAPS 2025 8th World Congress of Pediatric Surgery

AHMET ENES KARTAL ¹, münire kübra özgök kangal ², Sevim Ecem Ünlü Ballı ¹, Taylan Zaman ², Gökhan Berktuğ Bahadır ¹, Recep Özkan ², Osman Türkmen ², İlhami Sürer ¹

¹ Department of Pediatric Surgery, Health Sciences University Gulhane Medical Faculty
² Underwater and Hyperbaric Medicine, SBU- Gulhane Research and Training Hospital

Introduction

Hyperbaric oxygen therapy(HBOT), however, has shown promising results in animal models of ischemia-reperfusion injury in testicular torsion-detorsion. There are no clinical studies reported except for a single case report. We aimed to evaluate the outcomes of patients with testicular torsion who underwent HBOT after surgery.

Materials&Methods

This preliminary study was conducted retrospectively between 2017-2025. Patients(n=24) who underwent successful detorsion surgery within 24 hours of diagnosis were included.

The median time from symptom onset to surgery was 4.75-hours (range 1–14hours). Postoperatively, twelve-patients received HBOT, while the other 12-patients did not receive HBOT due to treatment refusal by the parents, HBOT intolerance or contraindications. Follow-up was available for 18-patients(mean duration 10.1±5.7months), and testicular atrophy was observed in only three patients(14.3%)

There were no statistically significant differences between the groups in terms of the duration of torsion(p = 0.446). The presence of testicular atrophy in the long-term was similar(p = 0.214). The Doppler-ultrasonography with elastography was performed in 14-patients but the comparison of Doppler-elastography parameters between HBOT and non-HBOT groups revealed no significant differences in testicular volume (p=0.686), shear wave elastography(SWE)(p=0.170), or microvascular imaging (MVI)(p=0.208).

Discussion

Our clinical data did not reveal any statistically significant differences in testicular atrophy rate or Doppler parameters between groups during long-term follow-up period. Although not statistically significant, there was a tendency for lower SWE values—indicating reduced testicular stiffness—and higher MVI values—indicating enhanced microvascularity—in the HBOT group. The limited number of patients(n=14), no standardization in the torsion degrees in patients at the time of hospital admission and not enough long term follow-up period may have contributed to the lack of statistical significance and proper evaluation.