Association of testicular torsion in children with sleep awakening of seasonal variations

Various theories have been put forward regarding the occurrence of testicular torsion. In this study, the aim was to determine the relationship between the onset of torsion with awakening from sleep and seasonal characteristics. In this cross-sectional study, the data for patients aged 17 years and younger who were operated for testicular torsion between January 2014 and June 2023 were evaluated retrospectively. The age range of 66 patients operated with the diagnosis of testicular torsion was 14 days–17 years. In 31 patients (46.9 %), there was a history of sudden scrotal pain that started with awakening from sleep in the morning. Of these patients, 7 were newborns and 18 were children over 10 years of age. While 12 of these patients underwent immediate orchiectomy, 3 patients underwent late orchiectomy procedure. Seasonally, no statistically significant difference was observed in winter, spring and summer (p > 0.05). A significant difference was observed for the comparison of the cases seen in the other three seasons with the autumn months (p < 0.05). The fact that testicular torsion cases were not significantly higher in winter than other seasons, except autumn, led to the conclusion that environmental hypothermia was not an effective predisposing factor as previously considered. The fact that a history of testicular torsion starting with awakening from sleep was found in about half of the patients, it was concluded that further studies including sleep type and sleep duration are needed in these patients.