Delayed presentation with acute scrotal pain in ethnic minorities

Gray S1, Gkentzis A1, Lee L1, Pantelides M1
1Royal Bolton Hospital Foundation Trust, United Kingdom

Introduction:
Delayed presentation in acute testicular torsion increases risk of testicular loss. We investigated whether there is a delay in presentation with suspected torsion in patients from an ethnic minority.

Patients and Methods:
A retrospective audit of patients undergoing scrotal exploration for suspected torsion from September 2014-2019 was completed. Notes were used to identify time between onset of pain and presentation to hospital. Patients’ ethnicity was identified through voluntary demographic information. Median time to presentation was compared between ethnic minorities (EM) and white British (WB) patients, as well as exploration findings.

Results:
EM patients (n=29) with suspected torsion presented significantly later with a median of 19 hours (range1.3-192) compared to 4 hours (0.5-96) in WB patients (n=65). (p<0.001) In patients found to have torsion with or without testicular loss, EM patients (n=18) presented at a median of 17.5 hours (3.1-192) compared to 3 hours (0.5-84) in WB patients (n=33), a statistically significant delay. (p<0.001) The relative risk of EM requiring orchidectomy when presenting with torsion was 12.83.

Conclusion(s):
In our population, EM present later with acute scrotal pain, increasing their risk of testicular loss. More study is required to identify causes of delayed presentation in these patients with the aim of improving health education.