Testicular torsion on the Jos Plateau

In order to determine the pattern and the factors that influenced outcome, we retrospectively studied fifty-seven patients with torsion of the testis admitted to the Jos University Teaching hospital between August 1993 and July 2001. The age ranged from 2 to 55 years with a mean of 22.7 years. Majority (79%) of the patients were in the second and third decades of life. The main suspected precipitating factors in this study were cold weather and scrotal trauma; in 28% of the cases no cause could be ascertained. Eight (14%) patients presented within 4 hours and 35 (61%) presented after 24 hours of the onset of symptoms. Both sides were equally affected. Testicular pain, retraction and scrotal swelling were the most common presenting complaints. The highest incidence 65%) occurred between November and February when the weather on the Jos plateau is coldest. At surgery, 34 (60%) patients were found to have associated congenital anomalies; in 22 (39%) patients, the testis was non-viable. There was no mortality in this series and the complications were superficial wound infection (14%), testicular atrophy (7%) and sub-fertility (16%). High index of suspicion in a patient with acute scrotum, prompt and effective surgery will improve testicular salvage. Keywords: Testicular torsion, Early diagnosis, Prompt and Effective surgery. Resume Afin de decider la tendance et des facteurs qui influencent les resultat, nous avons retrospectivement etudie cinquante sept patients atteints de la torsion admis au centre hospitalo-universitaire de Jos entre aout 1999 et juillet 2001. La tranche d'âge etaient dans la deuxieme et la troisieme decennie de leur vie. Des facteurs les plus precipitamment presumes dans cet etude etaient temps froid et traumatisme scrotal, dans 28% des cas on ne peut pas determiner aucune cause. Huit soit 14% des patients se sont presentes en moins de 4 heures et 35 soit 61% se sont presentes apres 24 heures du debut des symptomes. Le deux cotes sont egalement concernes. Douleur du testicules retraction et la bosse scrotale etaient des plaintes les plus frequentes. La frequence la plus elevee 65% est arrivee entre novembre et fevrier quand le temps sur la plateau de Jos est trop froid. Pendant la chirurgie 34 soit 60% des patients etaient deja atteints des anomalies congenitales, chez 22 soit 39% des patients, les testi etaient non-viables. Il n'y a aucun cas de la mortalite dans cette serie et des complications sont des blessures d'infections superficielles 14%, atrophie du testicule 7% et sous fertilite 16%. Indice tres eleve des soupcons chez un patient atteint du scrotum aigu, la chirurgie efficace et rapide vont ameliorer des efforts de sauver le testicule.