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Martinez Hill - One of the best experts on this subject based on the ideXlab platform.
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Prospective Evaluation of Predictors of Testis Atrophy After Surgery for Testis Torsion in Children
Urology, 2018Co-Authors: Gwen M Grimsby, Kunj R Sheth, Melise Keays, Candace F Granberg, Vani S Menon, Daniel Dajusta, Lauren Ostrov, Bruce J Schlomer, Carlos Villanueva, Martinez HillAbstract:Objective To prospectively correlate pain duration, red scrotal skin, ultrasound appearance of Testis, and intraoperative Testis color to future Testis atrophy after acute testicular Torsion. Methods Patients 2 months-18 years old with unilateral acute scrotum were consecutively enrolled in a National Institutes of Health transcutaneous near-infrared spectroscopy study, with a subgroup analysis of the true Torsion group. Presence or absence of red scrotal skin, pain duration, testicular heterogeneity on preoperative ultrasound, and intraoperative Testis color based on a novel visual chart 5 minutes after deTorsion were recorded. All testes underwent orchiopexy regardless of appearance. Percent volume difference between normal and torsed testicles on follow-up ultrasound was compared between patients with and without risk factors. Results Thirty of 56 patients who had surgical deTorsion underwent scrotal ultrasound at a mean of 117 days after surgery. A color of black or hemorrhagic 5 minutes after deTorsion, pain duration >12 hours, and heterogeneous parenchyma on preoperative ultrasound were associated with significant Testis volume loss in follow-up compared with normal Testis. All patients with a black or hemorrhagic Testis had >80% volume loss. Erythematous scrotal skin was not significantly associated with smaller affected Testis volume in follow-up. Conclusion Based on the high atrophy rate, orchiectomy can be considered for testes that are black or hemorrhagic 5 minutes after deTorsion. Pain duration >12 hours and parenchymal heterogeneity on preoperative ultrasound were also associated with Testis atrophy. Red scrotal skin was not a reliable predictor of atrophy and should not delay exploration.
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transscrotal near infrared spectroscopy as a diagnostic test for Testis Torsion in pediatric acute scrotum a prospective comparison to gold standard diagnostic test study
The Journal of Urology, 2017Co-Authors: Bruce J Schlomer, Kunj R Sheth, Melise Keays, Gwen M Grimsby, Candace F Granberg, Vani S Menon, Daniel Dajusta, Lauren Ostrov, Martinez Hill, Emma SanchezAbstract:Purpose: A rapid test for testicular Torsion in children may obviate the delay for testicular ultrasound. In this study we assessed testicular tissue percent oxygen saturation (%StO2) measured by transscrotal near infrared spectroscopy as a diagnostic test for pediatric testicular Torsion.Materials and Methods: This was a prospective comparison to a gold standard diagnostic test study that evaluated near infrared spectroscopy %StO2 readings to diagnose testicular Torsion. The gold standard for Torsion diagnosis was standard clinical care. From 2013 to 2015 males with acute scrotum for more than 1 month and who were less than 18 years old were recruited. Near infrared spectroscopy %StO2 readings were obtained for affected and unaffected testes. Near infrared spectroscopy Δ%StO2 was calculated as unaffected minus affected reading. The utility of near infrared spectroscopy Δ%StO2 to diagnose Testis Torsion was described with ROC curves.Results: Of 154 eligible patients 121 had near infrared spectroscopy read...
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diagnosing testicular Torsion before urological consultation and imaging validation of the twist score
The Journal of Urology, 2016Co-Authors: Kunj R Sheth, Melise Keays, Gwen M Grimsby, Candace F Granberg, Vani S Menon, Daniel Dajusta, Lauren Ostrov, Martinez Hill, Emma Sanchez, David KuppermannAbstract:Purpose: The TWIST (Testicular Workup for Ischemia and Suspected Torsion) score uses urological history and physical examination to assess risk of Testis Torsion. Parameters include Testis swelling (2 points), hard Testis (2), absent cremasteric reflex (1), nausea/vomiting (1) and high riding Testis (1). While TWIST has been validated when scored by urologists, its diagnostic accuracy among nonurological providers is unknown. We assessed the usefulness of the TWIST score when determined by nonurological nonphysician providers, mirroring emergency room evaluation of acute scrotal pain.Materials and Methods: Children with unilateral acute scrotum were prospectively enrolled in a National Institutes of Health clinical trial. After undergoing basic history and physical examination training, emergency medical technicians calculated TWIST score and determined Tanner stage per pictorial diagram. Clinical Torsion was confirmed by surgical exploration. All data were captured into REDCap™ and ROC curves were used t...
Brent Mitchell - One of the best experts on this subject based on the ideXlab platform.
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do all children with an acute scrotum require exploration
The Journal of Urology, 1993Co-Authors: Evan J Kass, Kevin T Stone, Alexander A Cacciarelli, Brent MitchellAbstract:AbstractA total of 77 consecutive children ranging in age from 1 day to 17 years was evaluated for an acute scrotum by a single examiner (E.J. K.). In 10 children a definite diagnosis of acute spermatic cord Torsion was made based upon the history and physical examination. No imaging studies were performed and Torsion was confirmed at surgery in 9 children. The diagnosis of Testis Torsion was not as clear-cut in the remaining 67 children and, therefore, a color Doppler ultrasound was performed before any surgical intervention. The study demonstrated normal or increased blood flow in 55 of these children and none proved to have testicular Torsion, although other scrotal pathology requiring surgery was noted in 5 children. Twelve children did not demonstrate evidence of testicular blood flow on the color Doppler ultrasound and all had surgical confirmation of Testis Torsion. We conclude that in our experience the majority (71%) of children with an acute scrotum did not require immediate surgical exploration...
Paula K Shultz - One of the best experts on this subject based on the ideXlab platform.
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color doppler ultrasound in newborn Testis Torsion
Urology, 1995Co-Authors: Patrick C Cartwright, Brent W Snow, Barbara S Reid, Paula K ShultzAbstract:Abstract Objectives To assess the usefulness of color Doppler ultrasound in evaluating the newborn with suspected antenatal Testis Torsion. Methods Nine newborns with 10 antenatally torsed testes were examined using color Doppler and gray-scale ultrasound. Results Each examination revealed lack of intratesticular blood flow on the affected side and normal flow within the contralateral Testis. In addition, gray-scale sonographic architecture of the affected testes appeared to reflect the duration of in utero Torsion. Conclusions Color Doppler sonography accurately assesses intratesticular blood flow in newborns with antenatal Testis Torsion and offers interesting details.
Kunj R Sheth - One of the best experts on this subject based on the ideXlab platform.
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Prospective Evaluation of Predictors of Testis Atrophy After Surgery for Testis Torsion in Children
Urology, 2018Co-Authors: Gwen M Grimsby, Kunj R Sheth, Melise Keays, Candace F Granberg, Vani S Menon, Daniel Dajusta, Lauren Ostrov, Bruce J Schlomer, Carlos Villanueva, Martinez HillAbstract:Objective To prospectively correlate pain duration, red scrotal skin, ultrasound appearance of Testis, and intraoperative Testis color to future Testis atrophy after acute testicular Torsion. Methods Patients 2 months-18 years old with unilateral acute scrotum were consecutively enrolled in a National Institutes of Health transcutaneous near-infrared spectroscopy study, with a subgroup analysis of the true Torsion group. Presence or absence of red scrotal skin, pain duration, testicular heterogeneity on preoperative ultrasound, and intraoperative Testis color based on a novel visual chart 5 minutes after deTorsion were recorded. All testes underwent orchiopexy regardless of appearance. Percent volume difference between normal and torsed testicles on follow-up ultrasound was compared between patients with and without risk factors. Results Thirty of 56 patients who had surgical deTorsion underwent scrotal ultrasound at a mean of 117 days after surgery. A color of black or hemorrhagic 5 minutes after deTorsion, pain duration >12 hours, and heterogeneous parenchyma on preoperative ultrasound were associated with significant Testis volume loss in follow-up compared with normal Testis. All patients with a black or hemorrhagic Testis had >80% volume loss. Erythematous scrotal skin was not significantly associated with smaller affected Testis volume in follow-up. Conclusion Based on the high atrophy rate, orchiectomy can be considered for testes that are black or hemorrhagic 5 minutes after deTorsion. Pain duration >12 hours and parenchymal heterogeneity on preoperative ultrasound were also associated with Testis atrophy. Red scrotal skin was not a reliable predictor of atrophy and should not delay exploration.
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transscrotal near infrared spectroscopy as a diagnostic test for Testis Torsion in pediatric acute scrotum a prospective comparison to gold standard diagnostic test study
The Journal of Urology, 2017Co-Authors: Bruce J Schlomer, Kunj R Sheth, Melise Keays, Gwen M Grimsby, Candace F Granberg, Vani S Menon, Daniel Dajusta, Lauren Ostrov, Martinez Hill, Emma SanchezAbstract:Purpose: A rapid test for testicular Torsion in children may obviate the delay for testicular ultrasound. In this study we assessed testicular tissue percent oxygen saturation (%StO2) measured by transscrotal near infrared spectroscopy as a diagnostic test for pediatric testicular Torsion.Materials and Methods: This was a prospective comparison to a gold standard diagnostic test study that evaluated near infrared spectroscopy %StO2 readings to diagnose testicular Torsion. The gold standard for Torsion diagnosis was standard clinical care. From 2013 to 2015 males with acute scrotum for more than 1 month and who were less than 18 years old were recruited. Near infrared spectroscopy %StO2 readings were obtained for affected and unaffected testes. Near infrared spectroscopy Δ%StO2 was calculated as unaffected minus affected reading. The utility of near infrared spectroscopy Δ%StO2 to diagnose Testis Torsion was described with ROC curves.Results: Of 154 eligible patients 121 had near infrared spectroscopy read...
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diagnosing testicular Torsion before urological consultation and imaging validation of the twist score
The Journal of Urology, 2016Co-Authors: Kunj R Sheth, Melise Keays, Gwen M Grimsby, Candace F Granberg, Vani S Menon, Daniel Dajusta, Lauren Ostrov, Martinez Hill, Emma Sanchez, David KuppermannAbstract:Purpose: The TWIST (Testicular Workup for Ischemia and Suspected Torsion) score uses urological history and physical examination to assess risk of Testis Torsion. Parameters include Testis swelling (2 points), hard Testis (2), absent cremasteric reflex (1), nausea/vomiting (1) and high riding Testis (1). While TWIST has been validated when scored by urologists, its diagnostic accuracy among nonurological providers is unknown. We assessed the usefulness of the TWIST score when determined by nonurological nonphysician providers, mirroring emergency room evaluation of acute scrotal pain.Materials and Methods: Children with unilateral acute scrotum were prospectively enrolled in a National Institutes of Health clinical trial. After undergoing basic history and physical examination training, emergency medical technicians calculated TWIST score and determined Tanner stage per pictorial diagram. Clinical Torsion was confirmed by surgical exploration. All data were captured into REDCap™ and ROC curves were used t...
Gwen M Grimsby - One of the best experts on this subject based on the ideXlab platform.
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Prospective Evaluation of Predictors of Testis Atrophy After Surgery for Testis Torsion in Children
Urology, 2018Co-Authors: Gwen M Grimsby, Kunj R Sheth, Melise Keays, Candace F Granberg, Vani S Menon, Daniel Dajusta, Lauren Ostrov, Bruce J Schlomer, Carlos Villanueva, Martinez HillAbstract:Objective To prospectively correlate pain duration, red scrotal skin, ultrasound appearance of Testis, and intraoperative Testis color to future Testis atrophy after acute testicular Torsion. Methods Patients 2 months-18 years old with unilateral acute scrotum were consecutively enrolled in a National Institutes of Health transcutaneous near-infrared spectroscopy study, with a subgroup analysis of the true Torsion group. Presence or absence of red scrotal skin, pain duration, testicular heterogeneity on preoperative ultrasound, and intraoperative Testis color based on a novel visual chart 5 minutes after deTorsion were recorded. All testes underwent orchiopexy regardless of appearance. Percent volume difference between normal and torsed testicles on follow-up ultrasound was compared between patients with and without risk factors. Results Thirty of 56 patients who had surgical deTorsion underwent scrotal ultrasound at a mean of 117 days after surgery. A color of black or hemorrhagic 5 minutes after deTorsion, pain duration >12 hours, and heterogeneous parenchyma on preoperative ultrasound were associated with significant Testis volume loss in follow-up compared with normal Testis. All patients with a black or hemorrhagic Testis had >80% volume loss. Erythematous scrotal skin was not significantly associated with smaller affected Testis volume in follow-up. Conclusion Based on the high atrophy rate, orchiectomy can be considered for testes that are black or hemorrhagic 5 minutes after deTorsion. Pain duration >12 hours and parenchymal heterogeneity on preoperative ultrasound were also associated with Testis atrophy. Red scrotal skin was not a reliable predictor of atrophy and should not delay exploration.
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transscrotal near infrared spectroscopy as a diagnostic test for Testis Torsion in pediatric acute scrotum a prospective comparison to gold standard diagnostic test study
The Journal of Urology, 2017Co-Authors: Bruce J Schlomer, Kunj R Sheth, Melise Keays, Gwen M Grimsby, Candace F Granberg, Vani S Menon, Daniel Dajusta, Lauren Ostrov, Martinez Hill, Emma SanchezAbstract:Purpose: A rapid test for testicular Torsion in children may obviate the delay for testicular ultrasound. In this study we assessed testicular tissue percent oxygen saturation (%StO2) measured by transscrotal near infrared spectroscopy as a diagnostic test for pediatric testicular Torsion.Materials and Methods: This was a prospective comparison to a gold standard diagnostic test study that evaluated near infrared spectroscopy %StO2 readings to diagnose testicular Torsion. The gold standard for Torsion diagnosis was standard clinical care. From 2013 to 2015 males with acute scrotum for more than 1 month and who were less than 18 years old were recruited. Near infrared spectroscopy %StO2 readings were obtained for affected and unaffected testes. Near infrared spectroscopy Δ%StO2 was calculated as unaffected minus affected reading. The utility of near infrared spectroscopy Δ%StO2 to diagnose Testis Torsion was described with ROC curves.Results: Of 154 eligible patients 121 had near infrared spectroscopy read...
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diagnosing testicular Torsion before urological consultation and imaging validation of the twist score
The Journal of Urology, 2016Co-Authors: Kunj R Sheth, Melise Keays, Gwen M Grimsby, Candace F Granberg, Vani S Menon, Daniel Dajusta, Lauren Ostrov, Martinez Hill, Emma Sanchez, David KuppermannAbstract:Purpose: The TWIST (Testicular Workup for Ischemia and Suspected Torsion) score uses urological history and physical examination to assess risk of Testis Torsion. Parameters include Testis swelling (2 points), hard Testis (2), absent cremasteric reflex (1), nausea/vomiting (1) and high riding Testis (1). While TWIST has been validated when scored by urologists, its diagnostic accuracy among nonurological providers is unknown. We assessed the usefulness of the TWIST score when determined by nonurological nonphysician providers, mirroring emergency room evaluation of acute scrotal pain.Materials and Methods: Children with unilateral acute scrotum were prospectively enrolled in a National Institutes of Health clinical trial. After undergoing basic history and physical examination training, emergency medical technicians calculated TWIST score and determined Tanner stage per pictorial diagram. Clinical Torsion was confirmed by surgical exploration. All data were captured into REDCap™ and ROC curves were used t...