Academic Journal
Impact of transfer status, time to operation, and orchiectomy rates in pediatric testicular torsion: A retrospective cohort analysis.
| Τίτλος: | Impact of transfer status, time to operation, and orchiectomy rates in pediatric testicular torsion: A retrospective cohort analysis. |
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| Συγγραφείς: | Erpenbeck SP; Department of Urology, Medical College of Wisconsin, 8701 Watertown Plank Rd, Wauwatosa, WI, 53226, United States. Electronic address: erpenbecksarah@gmail.com., Moturu A; Department of Research and Optimal Patient Care, American College of Surgeons, 633 N Saint Clair St, Chicago, IL, 60611, United States; Department of Surgery, Stanford Healthcare, 500 Pasteur Drive, Stanford, CA, 94304, United States., Ko CY; Department of Research and Optimal Patient Care, American College of Surgeons, 633 N Saint Clair St, Chicago, IL, 60611, United States., Saito JM; Department of Surgery, Children's National Hospital, 111 Michigan Avenue, NW, Washington, D.C., 20010, United States., Finkelstein JB; Department of Urology, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, United States., Ellison JS; Department of Urology, Medical College of Wisconsin, 8701 Watertown Plank Rd, Wauwatosa, WI, 53226, United States. |
| Πηγή: | Journal of pediatric urology [J Pediatr Urol] 2026 Aug; Vol. 22 (4), pp. 105882. Date of Electronic Publication: 2026 Mar 12. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Elsevier Country of Publication: England NLM ID: 101233150 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-4898 (Electronic) Linking ISSN: 14775131 NLM ISO Abbreviation: J Pediatr Urol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Kidlington, Oxford, UK : Elsevier, c2005- |
| Ιατρικοί όροι (MeSH): | Spermatic Cord Torsion*/surgery , Orchiectomy*/statistics & numerical data , Patient Transfer*/statistics & numerical data , Time-to-Treatment*/statistics & numerical data, Male ; Humans ; Retrospective Studies ; Adolescent ; Infant ; Child, Preschool ; Child ; Infant, Newborn ; Time Factors ; Treatment Delay |
| Περίληψη: | Introduction: Testicular torsion is a time-sensitive pediatric emergency, with delays in care potentially leading to testicular loss (i.e., orchiectomy). Transfer to pediatric specialty hospitals may prolong time to operation. The National Surgical Quality Improvement Program - Pediatric (NSQIP-Ped) collects process measures for time-sensitive operations, including transfer status, defined as whether a patient was transferred to the operating hospital. Several NSQIP-Ped hospitals additionally participated in a Testicular Torsion Collaborative convened to improve torsion care processes. In this study, we sought to evaluate the association between patient transfer and testicular salvage. Patients and Methods: This retrospective cohort analysis included non-neonate pediatric patients (0-17 years) from the NSQIP-Ped database who underwent non-elective surgery for testicular torsion between January 2022 and May 2024. Patients with symptom duration >24 h and unknown transfer status were excluded. Orchiectomy was modeled using mixed-effects logistic regression, clustering by institution and comparing on transfer status. Median time to mobilize a patient to operative intervention was compared across transfer status and Testicular Torsion Collaborative participation using nonparametric tests. Results: Among 2801 included cases from 74 institutions, 51.0 % (1415/2801) presented directly to NSQIP-Ped hospitals, 88.0 % (2467/2801) had time to operation <4 h, and 8.7 % (244/2801) underwent orchiectomy. Testicular Torsion Collaborative institutions performed 54.0 % (1514/2801) of operations. Transfer status was not associated with orchiectomy (OR: 1.2, 95 % CI: 0.9-1.6). Non-Testicular Torsion Collaborative institutions were associated with higher odds of orchiectomy (OR: 2.3, 95 % CI: 1.5-3.4). Among transferred patients, there was no difference in median time to mobilize between transferred versus non-transferred patients (111 vs 117 min, p = 0.23). However, among Testicular Torsion Collaborative institutions, the median time to mobilize was shorter than non- Testicular Torsion Collaborative institutions (102 vs 118 min, p < 0.01). Conclusion: While transfer status was not associated with differences in testicular salvage, Testicular Torsion Collaborative participation was independently associated with a reduced likelihood of orchiectomy. These results emphasize opportunities to improve testicular salvage for testicular torsion through collaboration. (Copyright © 2026 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.) |
| Competing Interests: | Conflict of interest statement There are no conflicts to disclose. |
| Contributed Indexing: | Keywords: Orchiectomy; Orchiopexy; Patient transfer; Testicular torsion |
| Entry Date(s): | Date Created: 20260327 Date Completed: 20260715 Latest Revision: 20260715 |
| Update Code: | 20260715 |
| DOI: | 10.1016/j.jpurol.2026.105882 |
| PMID: | 41895038 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1873-4898 |
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| DOI: | 10.1016/j.jpurol.2026.105882 |