Testicular torsion: An assessment of knowledge and referral pattern among health care workers in primary health-care facilities in Auchi, Nigeria

Abstract

Objectives: Testicular torsion is the twisting of the spermatic cord with attendant loss of the blood supply to the affected testis. It is a common urological emergency and one of the frequent causes of acute scrotum in adolescents and young adults. Prompt diagnosis and immediate surgical intervention are necessary for testicular salvage. Testicular loss is directly linked to delay in presentation, surgery, and the referral patterns at the point of the first contact with health-care providers. The purpose of our study is to assess the knowledge, management methods, and referral pattern among health care workers in the primary health-care facilities in Auchi primary health-care zone, Nigeria. Material and Methods: This was a cross-sectional carried out among primary health care workers in Auchi primary health-care zone between May and October 2020. A structured self-administered questionnaire was given to all the first contact health care workers in this zone. The knowledge, management, and referral pattern of testicular torsion were determined based on responses to the questionnaires. Data were analyzed using SPSS version 21. Results were displayed with frequency distribution tables and charts. Results: Eighty-seven health care workers met the inclusion criteria and were given questionnaires to fill. The mean age of the respondents was 37.74 ± 7.53 years. The majority of the health workers (n = 66, 75.9%) have more than 5 years’ experience with only 12 (13.8%) having a secondary level of education. Most respondents have heard of testicular torsion (n = 77, 88.5%) and know the symptoms (n = 68, 78.2%) but they have a poor knowledge of the age group predominantly affected (n = 36, 41.1%) and testicular survival time following torsion (n= 41, 47.7%). Only about a third (n = 28, 32.2%) had attended to patients with testicular torsion. Of the 28 health workers who had managed patients with testicular torsion, less than half (n = 11, 39.3%) referred almost immediately, while about half treated conservatively (n = 14, 49.9%) keeping the patients under their care for a period of 3–7 days. Conclusion: This study showed that a comprehensive education of all categories of health workers in the primary health-care centers is needed. This is necessary for the early identification and appropriate surgical intervention or prompt referral of patients with testicular torsion to prevent avoidable testicular losses.