Our Experience in the Management of Spermatic Cord Torsion (SCT) in Adults in Urology at Cocody-Abidjan University Hospital in 10 Years (2014-2023)

Abstract

Background : SCT is an absolute surgical emergency. It threatens the functional and vital prognosis of the testicle. This can harm subsequent fertility. Objective: To study the factors influencing testicular viability during SCT in adults. Methods: Retrospective cohort of 31 patients in the urology department of the Cocody University Hospital over a 10-year period from January 2014 to December 2023. Results: The mean age of the patients was 25.39 years, with extremes of 18 and 54 years. The mean consultation time was 48.5 hours (2 days 30 minutes) with extremes of 1 hour 20 minutes and 4 days. The pain of the scrotum represented the main reason for consultation in 30/31. The right testicle was the most affected, with 20/31 against 11/31 for the left testicle. 31 exploratory scrotal incisions were performed on 31 suspected cases of SCT. The mean time of management was 9.06 hours, with extremes of 2 and 48 hours. 19 (19/31) patients consulted late (after 6 hours), and 14 (14/31) consulted early (before 6 hours). A total of 12 (12/31) orchiectomies were performed, of which 3 (3/14) were consulted before 6 am but operated late and 8 (8/19) late. There were multiple turns of coils in all patients (12) with testicular necrosis. There was no significant correlation between laterality, pathology associated with the testis, and testicular necrosis (statistical test X2 with a significant P value at the 5% threshold). The mean length of hospitalization was 3.68 days, with extremes of 2 and 6 days. Conclusion s : SCT also occurs in young adults. The delay in consultation and the existence of several turns of spirals explain the high rate of orchiectomy. Awareness of the population and medical personnel is necessary to reverse this clinical profile, which will have disastrous consequences on the subsequent fertility of patients.