AB197. SOH21AS254. Scrotal exploration in a model 3 hospital 2017–2020: case series study and quality improvement pathway implementation

Background: Testicular torsion affects one in four thousand young men, with 65% occurring between the age of twelve to eighteen. Testicular torsion can cause rapid ischaemia with a marked reduction in testicle salvageable rates from 90% to <8% within 24 hours. It is a true surgical emergency.

Methods: We performed a retrospective review of patients who underwent scrotal exploration in a model 3 hospital from September 2017 to August 2020. Data points were collected from operation notes, electronic patient records and patient charts. Data collected was processed with SPSS software.

Results: Fifty-one patients had a scrotal exploration performed over this time period. Mean age was 17.4 years (range, 7–37 years). The mean time of the onset of symptoms to the presentation was 12.5 hours (range, 1–72 hours), with only 31% presenting within 4 hours of the onset of symptoms. One hundred percent of patients reporting pain as their primary symptom. Forty-seven percent of patients who had a scrotal exploration performed were confirmed as testicular torsion, with a further 36% having another pathology confirmed at time of surgery. The mean time from presentation to knife to skin was 230 minutes (range, 98–690 minutes). One hundred percent of patients had bilateral orchidopexy performed.

Conclusions: In what is a true surgical emergency, our data shows we have implemented timely interventions in this cohort of patients. To strive to further improve our patient care we have implemented an Acute Scrotal Pathway and we will review our outcomes again in May 2021.

Keywords: Acute scrotum; quality improvement; testicular torsion; scrotal exploration; surgical emergency