WOFAPS 2025 8th World Congress of Pediatric Surgery

Umar Daniyal, Jacob Peace, Vikash Patel

London North West University Healthcare

Acute use of testicular ultrasound via SAU for testicular pain >24 hours

Authors:
Umar Daniyal
Jacob Peace
Vikash Patel

Purpose
This audit investigates the practice of arranging next-day ultrasounds via the Surgical Assessment Unit (SAU) for patients presenting with testicular pain lasting more than 24 hours. This duration of pain often represents a grey area in management. The audit addresses concerns regarding increased day team workload, potential misuse of acute imaging resources, and minimal changes in patient management following imaging.

Method
A retrospective and prospective data collection was conducted from October 2024 to February 2025 using the Cerner electronic patient record. The study included patients who had experienced testicular pain for over 24 hours and underwent planned ultrasound via SAU. Patients not meeting these criteria were excluded. Data were recorded and analysed using Excel. The sample size was 19.

Results
Of the 19 patients, 47% were sent home directly. Only 3 patients experienced a change in management post-ultrasound. Two patients eventually underwent surgery after initially declining. Notably, 21% of patients were not reviewed by a registrar prior to the ultrasound.

Conclusion
Ultrasound use in this context led to limited changes in patient management. Recommendations include creating a local guideline for testicular pain, promoting education on the Getting It Right First Time (GIRFT) protocols, ensuring all patients are reviewed by the on-call team before ultrasound, and reassessing the audit using validated tools for workload and follow-up.