TY  - EJOU
AU  - Kılıç, Sinan 

TI  - Effectiveness of manual detorsion in the treatment of testicular torsion: systematic review and meta-analysis
T2  - Canadian Journal of Urology

PY  - 
VL  - 
IS  - 
SN  - 1488-5581

AB  -  <b>Objectives:</b> Testicular torsion is the most common surgical cause of an acute scrotum. Manuel detorsion renewed attention as a practical initial treatment, particularly in the COVID-19 pandemic. This study aims to systematically review and meta-analyze the current literature to determine whether manual detorsion offers a viable alternative to immediate surgery in improving testicular salvage rates. <b>Methods:</b> A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and registered with PROSPERO (CRD420251039489). Studies including ≥30 male patients comparing manual detorsion and surgical exploration were included. Searches were performed in PubMed/MEDLINE, Scopus, TR Index, and Web of Science. Risk of bias was assessed using a predefined scoring system based on methodology, sample size, and follow-up objectivity. Data were synthesized using RevMan 5.4 to calculate pooled risk ratios. <b>Results:</b> Eight retrospective studies involving a total of 670 patients were included. Patients were divided into a manual detorsion group (G1, <i>n</i> = 394) and a surgical exploration group (G2, <i>n</i> = 316). Success rates of manual detorsion ranged from 15% to 76%, while orchiectomy rates were lower in G1 (0% to 10.3%) compared to G2 (0% to 43.8%). The pooled success rate of manual detorsion was 75.7%. Although orchiectomy rates appeared numerically lower in the manual detorsion group (3.8% vs. 29.2%), the pooled analysis did not demonstrate a statistically significant overall difference between the two groups (risk ratio [RR] = 1.23; 95% CI: 0.82–1.84; <i>p</i> = 0.31). <b>Conclusion:</b> Manual detorsion appears time-saving and effective maneuver. To our knowledge, this is the first meta-analysis focused exclusively on manual detorsion, and it supports its consideration as an initial management strategy in selected clinical scenarios.
KW  - testicular torsion; manual detorsion; orchiopexy; testicular atrophy

DO  - 10.32604/cju.2025.072049