Testicular Torsion: An Analysis of Rural Geography and Socioeconomic Status

Tree, Kevin; Buckland, Benjamin Charles; Huynh, Roy; Baskaranathan, Sris; Fisher, Dean; Indrajit, Balasubramaniam

Title: Testicular Torsion: An Analysis of Rural Geography and Socioeconomic Status
Creator: Tree, Kevin; Buckland, Benjamin Charles; Huynh, Roy; Baskaranathan, Sris; Fisher, Dean; Indrajit, Balasubramaniam
Relation: Société Internationale d’Urologie Journal Vol. 4, Issue 4, p. 257-264
Publisher Link: http://dx.doi.org/10.48083/wkfe4169
Publisher: International Society of Urology
Resource Type: journal article
Date: 2023
Description: ObjectivesTesticular torsion is a time-critical, organ-threatening diagnosis requiring prompt surgical intervention for successful salvage of the organ. In Australia, 28% of individuals live in rural and remote areas and face barriers to health care such as greater distance, lower socioeconomic status, (SES), and limited health infrastructure. We hypothesize that these barriers would delay intervention and access to surgical care, and lead to higher orchidectomy rates.ObjectivesA 12-year retrospective audit was conducted at a large rural referral center in Australia, focusing on patients undergoing scrotal exploration for testicular torsion. Primary outcomes were orchidectomy rate, time to operation, and ultrasound (US) and their relationship with patient distance, SES, age, and peripheral hospital attendance. Data on SES for geographic postcodes was obtained from the Australian Government Socio-Economic Indexes for Areas 2016. Statistical analysis was performed using IBM SPSS Statistics software, and a P value < 0.05 was considered significant.ResultsThe study involved 107 patients, of whom 46% had left-sided pathology. The median age of the patients was 14 years. Median SES was in the 37% to 41% centile range, median distance from travelled was 62 kilometers, and median time to operation from triage was 194 minutes. Of the patients, 34 attended a peripheral hospital. No significant risk factors for orchidectomy were identified. US was used in 65% of cases, with torsion detected in 50% of those cases, and orchidectomy performed in 11 patients. US had a sensitivity of 86.1% and specificity of 52.9%.ConclusionDespite significant differences in geographical distance, SES, age, and access to health care, patients in rural and remote areas of Australia experienced equivalent outcomes in testicular torsion management. Testicular torsion was safely managed at a central referral center using a peripheral hospital catchment in rural and remote areas of Australia, despite significant time delays due to greater distance or lower SES.
Subject: orchidectomy; testis; testicular torsion; rural health
Identifier: http://hdl.handle.net/1959.13/1499557
Identifier: uon:54719
Identifier: ISSN:2563-6499
Language: eng
Reviewed

Hits: 300
Visitors: 300
Downloads: 0

		Thumbnail	File	Description	Size	Format