Journal of pediatric urology · 2025
Impact of seasonality and ambient temperature on testicular torsion incidence: A Mexican Nationwide population-based study.
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Arriaga-Izabal Diego, Morales-Lazcano Francisco, Canizalez-Román Adrián
Аннотация
INTRODUCTION: Testicular torsion is a surgical emergency characterized by twisting the spermatic cord, disrupting blood flow, and causing severe pain and swelling. It predominantly affects males aged 12 to 18, with an incidence of about 3.8 per 100,000 in this age group. Immediate surgical intervention is vital, as irreversible damage can occur within 4-6 h of symptom onset. Recent studies have suggested a correlation between low ambient temperatures and an increased incidence of testicular torsion, particularly in colder months.
OBJECTIVE: This study aims to analyze the relationship between temperature variations, seasonal trends, and testicular torsion incidence in Mexico from 2014 to 2024.
MATERIAL AND METHODS: A retrospective cohort study was conducted using a hospital admissions database from Mexico, covering December 2013 to July 2024. Patients diagnosed with testicular torsion (ICD-10 code N44X) aged 1 year or older were included, resulting in 3973 admissions after exclusions. ANOVA was used for seasonal difference analysis, and the Kruskal-Wallis U test was employed to examine climatic regions. Post-hoc comparisons utilized Tukey's test for monthly incidence. The Spearman rank test evaluated the correlation between mean monthly temperatures and incidence. A heatmap displayed monthly incidence by state.
RESULTS: Significant seasonal variations in incidence rates were observed: averages were 0.07 ± 0.02 in winter, 0.05 ± 0.02 in spring, 0.04 ± 0.02 in summer, and 0.05 ± 0.02 in fall (p = 0.001). Seasonal fluctuations correlated significantly with ambient temperatures (p < 0.001). Post-hoc analysis indicated that winter incidence was notably higher than in other seasons (p < 0.05). Monthly incidence rates were similar in temperate and tropical regions (p = 0.095) but higher than in the subtropical zone (p < 0.05). A moderate negative correlation between ambient temperature and monthly incidence was found, strongest in subtropical regions (R = -0.323, p = 0.000).
DISCUSSION: The present work is the first to comprehensively examine the relationship between ambient temperature and testicular torsion incidence in Mexico, showing significant seasonal patterns. The findings align with previous research in Latin America, suggesting lower temperatures increase the risk of torsion. Public health initiatives are crucial to raising awareness and potentially improving early diagnosis and management strategies.
CONCLUSION: A clear association between seasonal temperature fluctuations and testicular torsion incidence was observed, particularly during winter months in Mexico.
OBJECTIVE: This study aims to analyze the relationship between temperature variations, seasonal trends, and testicular torsion incidence in Mexico from 2014 to 2024.
MATERIAL AND METHODS: A retrospective cohort study was conducted using a hospital admissions database from Mexico, covering December 2013 to July 2024. Patients diagnosed with testicular torsion (ICD-10 code N44X) aged 1 year or older were included, resulting in 3973 admissions after exclusions. ANOVA was used for seasonal difference analysis, and the Kruskal-Wallis U test was employed to examine climatic regions. Post-hoc comparisons utilized Tukey's test for monthly incidence. The Spearman rank test evaluated the correlation between mean monthly temperatures and incidence. A heatmap displayed monthly incidence by state.
RESULTS: Significant seasonal variations in incidence rates were observed: averages were 0.07 ± 0.02 in winter, 0.05 ± 0.02 in spring, 0.04 ± 0.02 in summer, and 0.05 ± 0.02 in fall (p = 0.001). Seasonal fluctuations correlated significantly with ambient temperatures (p < 0.001). Post-hoc analysis indicated that winter incidence was notably higher than in other seasons (p < 0.05). Monthly incidence rates were similar in temperate and tropical regions (p = 0.095) but higher than in the subtropical zone (p < 0.05). A moderate negative correlation between ambient temperature and monthly incidence was found, strongest in subtropical regions (R = -0.323, p = 0.000).
DISCUSSION: The present work is the first to comprehensively examine the relationship between ambient temperature and testicular torsion incidence in Mexico, showing significant seasonal patterns. The findings align with previous research in Latin America, suggesting lower temperatures increase the risk of torsion. Public health initiatives are crucial to raising awareness and potentially improving early diagnosis and management strategies.
CONCLUSION: A clear association between seasonal temperature fluctuations and testicular torsion incidence was observed, particularly during winter months in Mexico.