Acute scrotal pain in children: results of 543 surgical explorations

A total of 543 boys suffering from acute scrotal pain underwent emergency s urgery between 1986 and 1996. Of these, 91 had a testicular torsion (TT) (1 6.8%) and 250 had an appendage torsion (AT) (46%). The cause varied with pa tient age, with most TTs in newborns and boys of 15 years and most ATs in 1 0-11-year-olds; 21.5% were operated upon within 6 h of the onset of pain an d 69.2% within 24 h. Most stayed in hospital for less than 24 h. Pre-surgic al examination identified no criterion for excluding TT. We therefore belie ve that all children complaining of acute scrotal pain should undergo surge ry. As release of an inflamed AT reduces pain, three-fourths of the childre n benefited directly from surgery.