Background to FIX-IT project
Testicular torsion is a common urological emergency, and when suspected mandates emergency scrotal exploration. Intra-operative findings can be heterogeneous, and decision making during this operation can be complex. Presently there is no guidance advocating for best practice, nor any robust data supporting any particular surgical technique. Consequently, we know that surgical technique can vary significantly.
Aims & Methods
The aim of the FInding consensus for OrchidopeXy In Torsion (FIX-IT) study was to derive a BAUS-endorsed best practice guideline for surgical technique based on expert consensus. In 2021, a two-round consensus study was conducted using RAND/UCLA consensus methodology. A panel of 16 surgeons representing adult, paediatric, general, and andrological sub-specialties took part. 184 statements were scored across 10 categories: consent, assessment under anaesthetic, initial incision, intra-operative decision making, fixation, medical photography, closure, operation note, logistics, and follow-up. Statements that were scored as agreement or disagreement with consensus were used to form the final consensus recommendations.
These consensus recommendations are a valuable document for surgeons to guide their practice for this common urological emergency.
These recommendations were presented at BAUS 2021 (Alexander Light) and USANZ 2022 (Veeru Kasivisvanathan).
The full paper can be viewed open access here: https://bjui-journals.onlinelibrary.wiley.com/doi/full/10.1111/bju.15818
