Introduction: Testicular torsion is unique among urological emergencies in that long term implications are not well established. Extended follow up is rarely performed following surgical intervention thereby creating a paucity in long term data. To our knowledge, the largest testicular torsion series included 72 patients with 15+ years of follow up. We sought to investigate the rates of infertility among patients previously treated for torsion using the largest known cohort to date.
Methods: A query was performed using the New York Statewide Planning and Research Cooperative System (SPARCS) database between 1994 and 2000. This comprehensive New York database includes patient characteristics from any surgical encounter, as well as all hospital and associated outpatient visits. Cases and controls were identified by ICD9 diagnosis and procedure codes. Adolescents surgically treated for testicular torsion were matched ( 1 to 1.1) by age, year of procedure ( +/- 1 year), and county to males undergoing circumcision for phimosis or redundant prepuce. The main outcome was an infertility diagnosis, procedure, or infertility treatment cycle between 2017 - 2020 based on ICD9/10, HCPCS, and SPARCS specific infertility treatment cycle codes. The database was queried for all cases of male infertility to demonstrate adequate capturing of outcomes data. Chi-square analysis was used to evaluate for significant differences in frequency.
Results: Between 1994 and 2000 a total of 2017 patients were surgically treated for testicular torsion, and a total of 2191 matched controls were identified (n = 4208). Mean age was 13.9 years (range 10-18). Among the cases and controls there were 6 diagnosed with infertility: 4 cases (0.2%) and 2 controls (0.1%) (p =0.436). None of the patients underwent infertility related surgery or initiated an infertility treatment cycle.
Conclusions: Our findings support previous literature - suggesting that there are no long term fertility implications following treatment for testicular torsion - using the largest and most current cohort known to date.
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