Evidence map›Paper›PMID 40272560›Full record

SynthesisWorld journal of urology2025

Effectiveness of tunica albuginea incision and tunica vaginalis flap for testicular torsion: a systematic review.

Juhyung Kim, Armando Lorenzo, Kay Chua Rivera, Alan Cheng, Jessie Cunningham, Joana Dos Santos, William Alexander Sy, Mandy Rickard, Jin Kyu Kim, Michael Erlano Chua

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Juhyung KimDepartment of Medicine, University of Melbourne, Parkville, VIC, Australia.
Armando LorenzoDivision of Urology, The Hospital for Sick Children, Toronto, ON, Canada.
Kay Chua RiveraInstitute of Urology, St. Luke's Medical Center, Quezon City, Philippines.
Alan ChengDepartment of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
Jessie CunninghamThe Hospital for Sick Children, Toronto, ON, Canada.
Joana Dos SantosDivision of Urology, The Hospital for Sick Children, Toronto, ON, Canada.
William Alexander SyInstitute of Urology, St. Luke's Medical Center, Quezon City, Philippines.
Mandy RickardDivision of Urology, The Hospital for Sick Children, Toronto, ON, Canada.
Jin Kyu KimRiley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA.
Michael Erlano ChuaDivision of Urology, The Hospital for Sick Children, Toronto, ON, Canada. michael.chua@sickkids.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTesticular torsion (TT) requires prompt surgical intervention to prevent irreversible damage or orchiectomy. While orchidopexy remains the standard treatment, the tunica vaginalis flap (TVF) has emerged as a novel technique to offer testicular salvage and reduce orchiectomy rates. This systematic review with meta-analysis aims to evaluate the TVF outcomes in TT patients.

methodsThis systematic review and meta-analysis adhered to the Cochrane collaborative and PRISMA guidelines. An extensive literature search was conducted up to December 2024. Data extracted included patient characteristics, surgical intervention description, postoperative outcomes, and complications. The ROBINS-I and MINORS tools were utilized to assess the quality of the study.

resultsEight studies with 293 patients were included. Meta-analysis of three comparative studies revealed that standard orchidopexy had a marginally higher testicular salvage rate than TVF pooled odds ratio of 2.33 (95% CI: 0.95-5.68, p = 0.06). However, this difference was not statistically significant. Testicular salvage rates were notably affected by the duration of ischemia, with prolonged ischemia linked to worse outcomes. Several studies highlighted TVF's effectiveness in preventing orchiectomy by decreasing testicular compartment pressure and postoperative testicular volume retention, maintaining at least 50% of testicular volume. Complications from the TVF procedure were rare. Most studies included in the analysis exhibited a high risk of bias.

conclusionTVF may be offered for its potential to preserve testicular volume and prevent orchiectomy, though its effectiveness depends on ischemic duration and procedural standardization. Further research is needed to better assess TVF's role in TT management and refine patient selection criteria.

Indexed as

OrchiopexySpermatic Cord TorsionSurgical FlapsHumansMaleOrchiectomyTestisTreatment OutcomeUrologic Surgical Procedures, MaleFasciotomyOrchidectomyOrchidopexyPediatric urologyTesticular torsion (TT)Tunica vaginalis flap (TVF)

Identifiers

PMID40272560

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.