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Contralateral Orchiopexy at the Time of Urgent Scrotal Exploration—Is It Safe? A Propensity Score Matched Analysis from the TORSAFUF Cohort

2021; Lippincott Williams & Wilkins; Volume: 206; Issue: 6 Linguagem: Inglês

10.1097/ju.0000000000002142

1527-3792

Igor Duquesne, Ugo Pinar, V. Dang, A. Mauger de Varennes, N. Ali Benali, William Berchiche, G. Margue, C. Gaillard, F. Bardet, M. Hulin, A. Manuguerra, C. Plassais, W. Wandoren, F. Lannes, Z. Khene, Benjamin Pradère,

Prostate Cancer Diagnosis and Treatment

No AccessJournal of UrologyAdult Urology1 Dec 2021Contralateral Orchiopexy at the Time of Urgent Scrotal Exploration—Is It Safe? A Propensity Score Matched Analysis from the TORSAFUF CohortThis article is commented on by the following:Editorial Comment Igor Duquesne, Ugo Pinar, Van Thi Dang, Anne Mauger de Varennes, Nadia Ali Benali, William Berchiche, Gaelle Margue, Charles Gaillard, Florian Bardet, Maud Hulin, Anthony Manuguerra, Caroline Plassais, William Wandoren, Francois Lannes, Zine-Eddine Khene, and Benjamin Pradere Igor DuquesneIgor Duquesne Department of Urology, Université de Paris, APHP, Hôpital Cochin, Paris, France , Ugo PinarUgo Pinar http://orcid.org/0000-0001-6135-1005 Department of Urology, Sorbonne Université, APHP, Hôpitaux Universitaires Pitie-Salpetriere-Charles Foix, Paris, France , Van Thi DangVan Thi Dang Department of Urology, Toulouse University Hospital, Toulouse, France , Anne Mauger de VarennesAnne Mauger de Varennes Department of Urology, Rennes University Hospital, Rennes, France , Nadia Ali BenaliNadia Ali Benali Department of Urology, Poitiers University Hospital, Poitiers, France , William BerchicheWilliam Berchiche Department of Urology, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France , Gaelle MargueGaelle Margue Department of Urology, Bordeaux University Hospital, Bordeaux, France , Charles GaillardCharles Gaillard Department of Urology, Tours University Hospital, Tours, France , Florian BardetFlorian Bardet Department of Urology, Dijon University Hospital, Dijon, France , Maud HulinMaud Hulin Department of Urology, Reims University Hospital, Reims, France , Anthony ManuguerraAnthony Manuguerra Department of Urology, Nancy University Hospital, Nancy, France , Caroline PlassaisCaroline Plassais Department of Urology, Sorbonne Université, APHP, Hôpitaux Universitaires Pitie-Salpetriere-Charles Foix, Paris, France , William WandorenWilliam Wandoren Department of Urology, Pointe à Pitre University Hospital, Guadeloupe, France , Francois LannesFrancois Lannes Department of Urology, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France , Zine-Eddine KheneZine-Eddine Khene Department of Urology, Rennes University Hospital, Rennes, France , and Benjamin PradereBenjamin Pradere †Correspondence: Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria telephone: +33661404418; E-mail Address: [email protected] https://orcid.org/0000-0002-7768-8558 Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria on behalf of the TORSAFUF Global Study Group View All Author Informationhttps://doi.org/10.1097/JU.0000000000002142AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluate the safety of immediate contralateral orchiopexy (ICLO) at the time of scrotal exploration for testicular torsion suspicion. Materials and Methods: Patient data were retrieved from the TORSAFUF cohort project, which is a multicenter national study conducted at 14 academic French hospitals between 2005 and 2019. Each patient who underwent surgical exploration for testicular torsion suspicion was included. The primary study outcome was the safety of ICLO compared to ipsilateral scrotal exploration alone. The primary outcome of interest was the complication rate within 90 days of surgery. The end point was planned before data collection. Results: Overall, 2,775 patients were included, of whom 1,554 (56%) underwent ICLO. After propensity score matching and multivariable analysis, ICLO was associated with a higher complication rate (OR 1.51, 95% CI 1.1–2.1, p=0.01), especially a higher rate of hematoma (OR 2.9, 95% CI 1.3–6.6, p=0.01), and delayed wound healing (OR 3.0, 95% CI 1.8–5.2, p <0.001). Conclusions: At the time of scrotal exploration for acute scrotum, ICLO was associated with an increased postoperative complication rate, with a particular increase in hematoma, and delayed wound healing. ICLO should not be performed systematically. REFERENCES 1. : Pediatric testicular torsion epidemiology using a national database: incidence, risk of orchiectomy and possible measures toward improving the quality of care. J Urol 2011; 186: 2009. Link, Google Scholar 2. : Torsion of the testis and allied conditions. Br J Surg 1976; 63: 465. Google Scholar 3. : Operative management of testicular torsion: current practice within the UK and Ireland. J Pediatr Urol 2006; 2: 190. Google Scholar 4. : Testicular fixation following torsion of the spermatic cord—does it guarantee prevention of recurrent torsion events?J Urol 2006; 175: 171. Link, Google Scholar 5. : Orchidopexy for testicular torsion: a systematic review of surgical technique. Eur Urol Focus 2020; S2405-4569: 30213. 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Link, Google Scholar In lieu of a formal ethics committee, the principles of the Helsinki Declaration were followed. © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited BySmith J (2021) This Month in Adult UrologyJournal of Urology, VOL. 206, NO. 6, (1349-1350), Online publication date: 1-Dec-2021.Related articlesJournal of UrologyAug 31, 2021, 12:00:00 AMEditorial Comment Volume 206Issue 6December 2021Page: 1461-1468 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.Keywordspostoperative complicationsscrotumspermatic cord torsionorchiopexyMetricsAuthor Information Igor Duquesne Department of Urology, Université de Paris, APHP, Hôpital Cochin, Paris, France Equal study contribution. More articles by this author Ugo Pinar Department of Urology, Sorbonne Université, APHP, Hôpitaux Universitaires Pitie-Salpetriere-Charles Foix, Paris, France Equal study contribution. More articles by this author Van Thi Dang Department of Urology, Toulouse University Hospital, Toulouse, France More articles by this author Anne Mauger de Varennes Department of Urology, Rennes University Hospital, Rennes, France More articles by this author Nadia Ali Benali Department of Urology, Poitiers University Hospital, Poitiers, France More articles by this author William Berchiche Department of Urology, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France More articles by this author Gaelle Margue Department of Urology, Bordeaux University Hospital, Bordeaux, France More articles by this author Charles Gaillard Department of Urology, Tours University Hospital, Tours, France More articles by this author Florian Bardet Department of Urology, Dijon University Hospital, Dijon, France More articles by this author Maud Hulin Department of Urology, Reims University Hospital, Reims, France More articles by this author Anthony Manuguerra Department of Urology, Nancy University Hospital, Nancy, France More articles by this author Caroline Plassais Department of Urology, Sorbonne Université, APHP, Hôpitaux Universitaires Pitie-Salpetriere-Charles Foix, Paris, France More articles by this author William Wandoren Department of Urology, Pointe à Pitre University Hospital, Guadeloupe, France More articles by this author Francois Lannes Department of Urology, La Conception University Hospital, Assistance-Publique Marseille, Marseille, France More articles by this author Zine-Eddine Khene Department of Urology, Rennes University Hospital, Rennes, France More articles by this author Benjamin Pradere Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria †Correspondence: Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria telephone: +33661404418; E-mail Address: [email protected] More articles by this author Expand All In lieu of a formal ethics committee, the principles of the Helsinki Declaration were followed. 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