eprintid: 10204461
rev_number: 12
eprint_status: archive
userid: 699
dir: disk0/10/20/44/61
datestamp: 2025-02-10 08:32:07
lastmod: 2025-02-10 08:33:35
status_changed: 2025-02-10 08:32:07
type: article
metadata_visibility: show
sword_depositor: 699
creators_name: Paediatric Surgery Trainee Research Network PSTRN, 
creators_name: British Urology Researchers Surgical Training BURST, 
creators_name: Boam, T
creators_name: Harwood, R
creators_name: Clement, KD
creators_name: Kasivisvanathan, V
creators_name: Light, A
creators_name: Bethell, GS
creators_name: Hotonu, S
creators_name: Eastwood, P
creators_name: Arthur, F
creators_name: Marks, I
creators_name: Tullie, L
creators_name: Rogoyski, BG
creators_name: Spurdens, A
creators_name: Nabarro, J
creators_name: Clarke, L
creators_name: Kulkarni, M
title: A national survey of practice for the emergency fixation of testis
ispublished: pub
divisions: UCL
divisions: B02
divisions: C10
divisions: D16
keywords: Testicular torsion; Orchidopexy; Genital diseases; Male; Testicular fixation; Scrotal exploration;
Acute scrotum
note: Copyright © 2025, The Authors. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License, https://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution, reproduction, and adaptation in any medium, provided the original work is properly attributed.
abstract: Introduction:
Scrotal exploration for suspected testicular torsion is a common emergency procedure in the United Kingdom (UK). There is no universally agreed practice for how the testis should be fixed, or whether a nontorted testis should receive fixation. This survey aims to describe the methods used for emergency scrotal exploration and testicular fixation in the UK.
//
Methods:
An online survey was distributed to urologists, general surgeons and specialist paediatric surgeons in approved NHS trusts, and via the email lists of collaborating organisations. The survey questioned surgeons on their operative management of a variety of common diagnoses encountered during scrotal exploration using multiple choice and free-text answers.
//
Results:
A total of 340 responses were received from 83 institutions. Respondents included urologists (consultants, 33%; trainees, 24%), paediatric surgeons (consultants, 12%; trainees, 16%) and general surgeons. In cases of torsion, respondents predominantly perform sutured fixation (74%); however, sutureless dartos pouch fixation was used frequently (37%) by paediatric surgeons. The finding of ‘bell-clapper’ anatomy without torsion prompts 69% of respondents to undertake sutured fixation, but alternative nontorsion diagnoses frequently prompt use of sutureless methods (53–66%).
//
Conclusion:
This study is the largest survey of methods for emergency scrotal exploration and describes current UK practice. The majority of surgeons prefer sutured fixation in cases of torsion and/or bell-clapper anomalies, and sutureless methods in the absence of it.
date: 2025-01
date_type: published
publisher: ROYAL COLL SURGEONS ENGLAND
official_url: https://doi.org/10.1308/rcsann.2023.0101
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 2358531
doi: 10.1308/rcsann.2023.0101
lyricists_name: Kasivisvanathan, Veerappan
lyricists_id: VKASI35
actors_name: Kasivisvanathan, Veerappan
actors_id: VKASI35
actors_role: owner
funding_acknowledgements: [Prostate Cancer UK]; [John Black Charitable Foundation]
full_text_status: public
publication: The Annals of The Royal College of Surgeons of England
volume: 107
number: 1
pagerange: 48-53
pages: 6
issn: 0035-8843
citation:        Paediatric Surgery Trainee Research Network PSTRN;    British Urology Researchers Surgical Training BURST;    Boam, T;    Harwood, R;    Clement, KD;    Kasivisvanathan, V;    Light, A;                                             ... Kulkarni, M; + view all <#>        Paediatric Surgery Trainee Research Network PSTRN;  British Urology Researchers Surgical Training BURST;  Boam, T;  Harwood, R;  Clement, KD;  Kasivisvanathan, V;  Light, A;  Bethell, GS;  Hotonu, S;  Eastwood, P;  Arthur, F;  Marks, I;  Tullie, L;  Rogoyski, BG;  Spurdens, A;  Nabarro, J;  Clarke, L;  Kulkarni, M;   - view fewer <#>    (2025)    A national survey of practice for the emergency fixation of testis.                   The Annals of The Royal College of Surgeons of England , 107  (1)   pp. 48-53.    10.1308/rcsann.2023.0101 <https://doi.org/10.1308/rcsann.2023.0101>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10204461/1/Kasivisvanathan_2024-a-national-survey-of-practice-for-the-emergency-fixation-of-testis.pdf