Torsion of the spermatic cord at the Yaounde Central Hospital

Abstract

Introduction: Spermatic cord torsion (SCT) is a surgical emergency whose delay in treatment determines the vital prognosis of the testicle. We therefore set out to study the epidemiological, clinical and therapeutic aspects of spermatic cord torsion at Yaoundé Central Hospital.

Methodology: We conducted a descriptive and retrospective study over a period of 05 years from 2020 to 2024 and a period of 09 months from September 2023 to May 2024 in the Urology and Andrology Department and the Surgical Emergency Department of the Yaoundé Central Hospital.

Results: We enrolled 48 patients. The median age was 23 years, ranging from 13 to 30 years. The median consultation time was 25 years. Twenty-one patients (43.75%) consulted before the first hour. Acute hemiscrotal pain was the main symptom. Swelling of the hemiscrotum, the presence of Gouverneur's sign and the absence of Prehn's sign were the most common physical signs. The median time to surgery was 8 hours. Intravaginal torsion was the most common. Orchiectomy was performed in 27 patients (56.25%).

Conclusion: SCT is diagnosed and managed late, resulting in a high rate of orchiectomy. To improve testicular prognosis, the public and healthcare staff need to be made more aware of the disease, diagnostic capabilities need to be strengthened and protocols for rapid management need to be put in place.