Suspected testicular torsion a survey of clinical practice among urology residents (trainees) and specialists (trainers) in Jordan

Abstract

Objective: To assess the clinical practice for suspected testicular torsion among urology specialists (trainers) and residents (trainees) in Jordan. Methods: electronic questionnaire containing nine questions regarding diagnosis and management of suspected testicular torsion was sent by E-mail to 70 urologists (35 residents and 35 specialists) selected randomly by stratified random sampling from different clinical societies (university hospitals, military, ministry of health and private hospitals) , 56 of them were returned complete ( 27 specialists and 29 residents) and 14 ( 8 specialists and 6 residents) didn’t respond back. Results: Although time is crucial in suspected testicular torsion emergency management, 74% (20) of specialists and 75.9% (22) of residents prefer to do a scrotal ultrasound (if available) rather than to explore immediately in suspected testicular torsion. Intra-operatively 55.6 % (15) of specialists and 44.8% (13) of residents choose midline scrotal incision to do scrotal exploration, and if testicular torsion is the case during exploration 77.8% (21) of specialists and 89.7% (26) of residents advise doing fixation of the other testes at the time of exploration, but if there is no torsion at the time of exploration 48.1% (13) of specialists and 41.4% (12) of residents do orchidopexy anyway. Regarding sutures used for fixation, 77.8 % (21) of specialists and 69% (20) of residents use absorbable sutures. Conclusion: This survey shows no significant difference in clinical practice for suspected testicular torsion between urology residents and specialists and raise the importance to formulate general guidelines for both diagnosis and management of this emergency situation.