Influence of pain duration on the prognosis of pediatric testicular torsion: A retrospective study in Quito (2019–2024)

Introduction: Testicular torsion is a urological emergency that requires prompt diagnosis and surgical management to preserve testicular viability. The time elapsed since symptom onset is considered the most important prognostic factor. 
Objective: To analyze the relationship between pain duration and surgical outcome (orchidopexy vs. orchiectomy) in pediatric patients with testicular torsion treated at a referral center in Quito, Ecuador. 
Materials and Methods: A retrospective, observational, and descriptive study was conducted using 112 clinical records of pediatric patients diagnosed with testicular torsion between 2019 and 2024. Variables analyzed included age, pain duration, and final surgical procedure (orchidopexy vs. orchiectomy). 
Results: The cohort was divided into two groups according to surgical outcome: orchidopexy (N=50) and orchiectomy (N=62). Mean pain duration was significantly shorter in the orchidopexy group (7.9 hours) than in the orchiectomy group (25.1 hours). Median pain duration was 6 hours in the orchidopexy group and 15.5 hours in the orchiectomy group. No statistically significant correlation was found between patient age and final outcome. 
Conclusions: Pain duration is a key predictor of testicular prognosis. Early surgical intervention—ideally within the first 6 hours after symptom onset—significantly increases the likelihood of testicular salvage. These findings reinforce the need for awareness campaigns targeting parents and healthcare professionals regarding immediate medical evaluation in suspected testicular torsion.