Clinical characteristics of testicular torsion in children and analysis of factors influencing testicular preservation

The main manifestation of pediatric testicular torsion is scrotal redness, swelling, and pain, with color Doppler ultrasonography as the preferred diagnostic tool. This study demonstrated that symptom duration is an independent risk factor affecting testicular outcome (OR =1.014; P=0.048), with longer duration associated with higher orchiectomy risk; torsion angle was also an independent predictor (OR =3.709). ROC analysis indicated 22 hours as the optimal cutoff for predicting necrosis (AUC =0.686). Although the "6-hour golden window" is widely accepted, our findings suggest that testes may still be salvageable in some delayed cases. Therefore, surgical exploration should not be withheld solely based on prolonged symptom duration. Even when the testis is preserved, there remains a high risk of atrophy, highlighting the importance of long-term follow-up.