Abstract

Testicular torsion is a condition in which the blood vessels supplying the testicles become twisted, resulting in
ischemia and an acute scrotum. It is a urologic emergency that requires prompt surgical intervention to prevent
testicular loss and subsequent infertility. The incidence of acute scrotum cases due to testicular torsion has been
increasing, leading to morbidity, infertility, and psychological distress. This study aimed to determine the
incidence and factors associated with early adverse outcomes of testicular torsion in patients with acute scrotum in
selected hospitals in western Uganda. The study was a prospective observational study conducted at Hoima
Regional Referral and Kampala International University Teaching Hospitals. Patients with acute scrotum were
enrolled and evaluated for testicular torsion. Those diagnosed with torsion underwent surgery, and the outcome in
terms of salvageability of the testis was recorded. The data were analyzed using SPSS version 22. During the
study period, 232 patients with acute scrotum were enrolled, with a mean age of 35.3 (SD = 20.4) years. Out of
these, 41 (17.7%) were diagnosed with testicular torsion. Only 16 (39.02%) of the torsion cases had a viable testis
that could be salvaged, while 25 (60.98%) required orchiectomy. Multivariate analysis showed that patients who
presented after 48 hours from the onset of symptoms were 34.833 times more likely to undergo orchiectomy
compared to those who presented within 12 hours (AOR=34.833, CI=5.020-60.711, P<0.001). This study found
a high incidence of testicular torsion and a significant proportion of patients requiring orchiectomy. The only
independent factor associated with orchiectomy was the duration from symptom onset to exploration. It is
important to educate males about the clinical signs of testicular torsion to ensure early presentation, which can
increase salvage rates and reduce the need for orchiectomy.
Keywords: Acute scrotum, Testicular torsion, Male infertility, Orchiectomy