The Acute Scrotum in Infancy: A retrospective regional study

Published:November 05, 2021DOI:https://doi.org/10.1016/j.jpurol.2021.10.021
      Neonatal torsion is already well covered in the literature so the interesting aspect of this study relates to infants aged 1 -12 months. It is unfortunate, therefore, that the potential value of the study is diminished by questions surrounding the quality of the authors’ data - which were based mainly on the subjective visual assessments of unsupervised surgical trainees at the time of operation. Corroborative diagnostic evidence from ultrasound, urine microbiology and histopathology is almost entirely lacking in this study. The authors did not perform ultrasound in any of their patients – which they claim was “ in keeping with UK practice for the management of the acute scrotum”. Whilst this applies to UK practice in older boys and adolescents (in whom testicular torsion accounts for more than 90% of cases) the authors provide no evidence that it also applies to UK practice in infants aged 1-12 months. When writing this commentary I surveyed 13 Consultant Paediatric Urologists/ Surgeons in 10 different centres throughout the UK. Unlike the authors (and contrary to the authors’ assertion regarding UK practice) the majority (77%) said that they would use ultrasound in their management of an infant aged 1-12 months with a one day history of scrotal symptoms.
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      Linked Article

      • The acute scrotum in infancy: A retrospective regional study
        Journal of Pediatric Urology
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          Testicular torsion during infancy (<1 year) is known to be a rare event with relatively few studies on the subject in the published scientific literature. We reviewed the experience of infant scrotal exploration within a paediatric surgical network of four centres serving an approximate paediatric population of 1.8 million.
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      • Response to commentary to ‘The acute scrotum in infancy: A retrospective regional study’
        Journal of Pediatric Urology
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          This commentary makes some very pertinent points and highlights limitations to our paper that we freely acknowledge. However, we feel there is a danger in dismissing a piece of work for what it isn't, rather than appreciating it for what it is. We do present a significant series of what happens in the real world to infants with an acute scrotum. The paediatric population from which it is drawn is estimated at 1.8 million in a very crowded part of London south of the Thames and the South-East of England (Kent, Surrey, Sussex).
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