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Craig A. Peters - One of the best experts on this subject based on the ideXlab platform.
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Testicular torsion and risk factors for Orchiectomy.
Archives of pediatrics & adolescent medicine, 2005Co-Authors: Jonathan M. Mansbach, Peter W. Forbes, Craig A. PetersAbstract: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.
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testicular torsion and risk factors for Orchiectomy
Journal of Adolescent Health, 2004Co-Authors: Jonathan M. Mansbach, Peter W. Forbes, Craig A. PetersAbstract:Design and Participants: Medical records of patientsaged1to25yearswithaprincipaldiagnosisoftesticular torsion were extracted from the 1998 NationwideInpatientSample.Population-basedratesoftesticular torsion and Orchiectomy were determined. Logistic regression was used to create a predictive model for Orchiectomy.Forcomparison,medicalrecordsofpatientsaged 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 100000 male subjects per year, and the estimated incidence of benign and malignant testicular tumors is 1.2 cases per 100000. 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.
Linda A Baker - One of the best experts on this subject based on the ideXlab platform.
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pediatric testicular torsion demographics of national orchiopexy versus Orchiectomy rates
The Journal of Urology, 2011Co-Authors: Nicholas G Cost, Rong Huang, Nicol Bush, Theodore Barber, Linda A BakerAbstract:Purpose: While the timely diagnosis and management of pediatric torsion can lead to testicular salvage, limited data exist on rates of orchiopexy vs Orchiectomy and associated factors. Thus, we examined the Pediatric Health Information System database for torsion outcomes and demographics at American pediatric hospitals.Materials and Methods: Using the Pediatric Health Information System database we performed a 7-year retrospective cohort study in children 1 to 17 years old with a primary ICD-9 diagnosis of torsion, assessing CPT codes for orchiopexy and Orchiectomy. Data were analyzed with SPSS®, version 17.0.Results: Of 2,876 patients who underwent surgery for an ICD-9 diagnosis code of testicular torsion 918 (31.9%) underwent Orchiectomy at a mean age of 10.7 years and 1,958 (68.1%) underwent orchiopexy at a mean age of 12.6 years (p <0.0001). In the age groups 1 to 9, 10 to 13 and 14 years or greater 274 (49.9%), 311 (29.4%) and 333 patients (26.2%), respectively, underwent Orchiectomy. A higher orchi...
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Pediatric testicular torsion: demographics of national orchiopexy versus Orchiectomy rates.
The Journal of urology, 2011Co-Authors: Nicholas G Cost, Nicol C Bush, Theodore D Barber, Rong Huang, Linda A BakerAbstract:While the timely diagnosis and management of pediatric torsion can lead to testicular salvage, limited data exist on rates of orchiopexy vs Orchiectomy and associated factors. Thus, we examined the Pediatric Health Information System database for torsion outcomes and demographics at American pediatric hospitals. Using the Pediatric Health Information System database we performed a 7-year retrospective cohort study in children 1 to 17 years old with a primary ICD-9 diagnosis of torsion, assessing CPT codes for orchiopexy and Orchiectomy. Data were analyzed with SPSS®, version 17.0. Of 2,876 patients who underwent surgery for an ICD-9 diagnosis code of testicular torsion 918 (31.9%) underwent Orchiectomy at a mean age of 10.7 years and 1,958 (68.1%) underwent orchiopexy at a mean age of 12.6 years (p <0.0001). In the age groups 1 to 9, 10 to 13 and 14 years or greater 274 (49.9%), 311 (29.4%) and 333 patients (26.2%), respectively, underwent Orchiectomy. A higher Orchiectomy rate was seen at age 1 to 9 vs 10 years or greater. Torsion and Orchiectomy rates did not vary by season or geographic region. A higher Orchiectomy rate was seen in black vs white children (37.6% vs 28.1%) and in patients without vs with private insurance (36.7% vs 27.0%). Multivariate analysis revealed an association of age (p <0.0001), race (p <0.0001) and insurance status (p <0.001) with Orchiectomy. Nationally an average of 32% of the 411 pediatric torsion cases explored annually result in Orchiectomy. Identified factors increasing the Orchiectomy risk included age 1 to 9 years, black race and lack of private insurance. Efforts should continue to identify modifiable variables that can increase testicular salvage in patients with testicular torsion. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Jonathan M. Mansbach - One of the best experts on this subject based on the ideXlab platform.
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Testicular torsion and risk factors for Orchiectomy.
Archives of pediatrics & adolescent medicine, 2005Co-Authors: Jonathan M. Mansbach, Peter W. Forbes, Craig A. PetersAbstract: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.
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testicular torsion and risk factors for Orchiectomy
Journal of Adolescent Health, 2004Co-Authors: Jonathan M. Mansbach, Peter W. Forbes, Craig A. PetersAbstract:Design and Participants: Medical records of patientsaged1to25yearswithaprincipaldiagnosisoftesticular torsion were extracted from the 1998 NationwideInpatientSample.Population-basedratesoftesticular torsion and Orchiectomy were determined. Logistic regression was used to create a predictive model for Orchiectomy.Forcomparison,medicalrecordsofpatientsaged 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 100000 male subjects per year, and the estimated incidence of benign and malignant testicular tumors is 1.2 cases per 100000. 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.
Aditya Bagrodia - One of the best experts on this subject based on the ideXlab platform.
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Initial results for combined Orchiectomy and prosthesis exchange for unsalvageable testicular torsion in adolescents: Description of intravaginal prosthesis placement at Orchiectomy
The Journal of Urology, 2012Co-Authors: Nicol Bush, Aditya BagrodiaAbstract:Purpose: Historically the placement of testicular prosthesis during Orchiectomy for torsion is delayed despite reports of safe prosthesis placement during mastectomy and Orchiectomy for cancer as well as the removal of infected penile prostheses. We describe our experience with intravaginal testicular prosthesis at Orchiectomy in adolescents with torsion.Materials and Methods: Consecutive pubertal patients undergoing exploration for torsion from 2010 to 2011 were offered Orchiectomy with staged prosthesis or combined Orchiectomy and prosthesis exchange for nonsalvageable testis. Through a midline scrotal incision the ipsilateral tunica vaginalis was opened, testis detorsed and contralateral orchiopexy performed. When verified as unviable, the ipsilateral spermatic cord was suture ligated within the tunica vaginalis and preplaced sutures secured the saline filled prosthesis in the tunica vaginalis. Patients were discharged home on the day of surgery with 5 days of oral antibiotics and narcotics. Demographi...
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Initial results for combined Orchiectomy and prosthesis exchange for unsalvageable testicular torsion in adolescents: description of intravaginal prosthesis placement at Orchiectomy.
The Journal of urology, 2012Co-Authors: Nicol Corbin Bush, Aditya BagrodiaAbstract:Historically the placement of testicular prosthesis during Orchiectomy for torsion is delayed despite reports of safe prosthesis placement during mastectomy and Orchiectomy for cancer as well as the removal of infected penile prostheses. We describe our experience with intravaginal testicular prosthesis at Orchiectomy in adolescents with torsion. Consecutive pubertal patients undergoing exploration for torsion from 2010 to 2011 were offered Orchiectomy with staged prosthesis or combined Orchiectomy and prosthesis exchange for nonsalvageable testis. Through a midline scrotal incision the ipsilateral tunica vaginalis was opened, testis detorsed and contralateral orchiopexy performed. When verified as unviable, the ipsilateral spermatic cord was suture ligated within the tunica vaginalis and preplaced sutures secured the saline filled prosthesis in the tunica vaginalis. Patients were discharged home on the day of surgery with 5 days of oral antibiotics and narcotics. Demographic, surgical and postoperative measures were prospectively recorded. Of 19 patients 6 had testes deemed salvageable at surgery with a median time to presentation of 6 hours (range 4 to 48) vs 96 (range 14 to 168, p = 0.002) in the 13 patients with nonsalvageable torsion. Of these patients 12 (median age 15 years, range 12 to 16) elected combined Orchiectomy and prosthesis exchange. With a median followup of 4.8 months (range 1.5 to 16) there were no infectious complications or extrusions. Eleven (91.7%) patients had a symmetric appearing scrotum with the prosthesis located in a mid to dependent scrotal position. We demonstrate the feasibility of intravaginal prosthesis placement for immediate scrotal reconstruction in adolescents with nonsalvageable testicular torsion. Advantages of combined Orchiectomy and prosthesis exchange include orthotopic prosthetic position, extra tunica vaginalis barrier layer and avoidance of a second anesthetic. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Nicholas G Cost - One of the best experts on this subject based on the ideXlab platform.
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pediatric testicular torsion demographics of national orchiopexy versus Orchiectomy rates
The Journal of Urology, 2011Co-Authors: Nicholas G Cost, Rong Huang, Nicol Bush, Theodore Barber, Linda A BakerAbstract:Purpose: While the timely diagnosis and management of pediatric torsion can lead to testicular salvage, limited data exist on rates of orchiopexy vs Orchiectomy and associated factors. Thus, we examined the Pediatric Health Information System database for torsion outcomes and demographics at American pediatric hospitals.Materials and Methods: Using the Pediatric Health Information System database we performed a 7-year retrospective cohort study in children 1 to 17 years old with a primary ICD-9 diagnosis of torsion, assessing CPT codes for orchiopexy and Orchiectomy. Data were analyzed with SPSS®, version 17.0.Results: Of 2,876 patients who underwent surgery for an ICD-9 diagnosis code of testicular torsion 918 (31.9%) underwent Orchiectomy at a mean age of 10.7 years and 1,958 (68.1%) underwent orchiopexy at a mean age of 12.6 years (p <0.0001). In the age groups 1 to 9, 10 to 13 and 14 years or greater 274 (49.9%), 311 (29.4%) and 333 patients (26.2%), respectively, underwent Orchiectomy. A higher orchi...
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Pediatric testicular torsion: demographics of national orchiopexy versus Orchiectomy rates.
The Journal of urology, 2011Co-Authors: Nicholas G Cost, Nicol C Bush, Theodore D Barber, Rong Huang, Linda A BakerAbstract:While the timely diagnosis and management of pediatric torsion can lead to testicular salvage, limited data exist on rates of orchiopexy vs Orchiectomy and associated factors. Thus, we examined the Pediatric Health Information System database for torsion outcomes and demographics at American pediatric hospitals. Using the Pediatric Health Information System database we performed a 7-year retrospective cohort study in children 1 to 17 years old with a primary ICD-9 diagnosis of torsion, assessing CPT codes for orchiopexy and Orchiectomy. Data were analyzed with SPSS®, version 17.0. Of 2,876 patients who underwent surgery for an ICD-9 diagnosis code of testicular torsion 918 (31.9%) underwent Orchiectomy at a mean age of 10.7 years and 1,958 (68.1%) underwent orchiopexy at a mean age of 12.6 years (p <0.0001). In the age groups 1 to 9, 10 to 13 and 14 years or greater 274 (49.9%), 311 (29.4%) and 333 patients (26.2%), respectively, underwent Orchiectomy. A higher Orchiectomy rate was seen at age 1 to 9 vs 10 years or greater. Torsion and Orchiectomy rates did not vary by season or geographic region. A higher Orchiectomy rate was seen in black vs white children (37.6% vs 28.1%) and in patients without vs with private insurance (36.7% vs 27.0%). Multivariate analysis revealed an association of age (p <0.0001), race (p <0.0001) and insurance status (p <0.001) with Orchiectomy. Nationally an average of 32% of the 411 pediatric torsion cases explored annually result in Orchiectomy. Identified factors increasing the Orchiectomy risk included age 1 to 9 years, black race and lack of private insurance. Efforts should continue to identify modifiable variables that can increase testicular salvage in patients with testicular torsion. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.