Testicular torsion and risk factors for orchiectomy

Objective: To determine risk factors for testicular loss due to testicular torsion. Design and Participants: Medical records of patients aged 1 to 25 years with a principal diagnosis of testicular torsion were extracted from the 1998 Nationwide Inpatient Sample. Population-based rates of testicular torsion and orchiectomy were determined. Logistic regression was used to create a predictive model for orchiectomy. For comparison, medical records of patients aged 1 to 25 years with a principal diagnosis of testicular neoplasm were extracted. Results: The sample comprised 436 participants. The estimated incidence of testicular torsion for males aged 1 to 25 years in the United States is 4.5 cases per 100 000 male subjects per year, and the estimated incidence of benign and malignant testicular tumors is 1.2 cases per 100 000. Of the estimated 2248 males diagnosed nationally in 1998 with testicular torsion, 762 (34%) had an orchiectomy. In the final multivariate model estimating the probability of orchiectomy, only age was significant. Conclusions: For males aged 1 to 25 years, testicular torsion is more common than testicular tumors, and increasing age is the sole identifiable risk factor for orchiectomy. We suggest that health care professionals educate prepubertal male patients about testicular torsion and the necessity of seeking timely care to reduce the risk of orchiectomy and of possible subsequent reduced fertility.