Clinical Research Directory

Evaluation of the Diagnostic Performance of the Testicular Workup for Ischemia and Suspected Torsion (TWIST) Score for Assessing the Risk of Testicular Torsion in Adult Patients Presenting to the Emergency Department With Scrotal Pain - A Prospective Observational Study

This prospective multicenter observational study aims to evaluate the diagnostic accuracy of the Testicular Workup for Ischemia and Suspected Torsion (TWIST) score in adult patients presenting with acute scrotal pain in Swedish Emergency Departments. The TWIST score is a clinical decision tool originally validated in pediatric populations to stratify patients into low, intermediate, and high risk for testicular torsion. The study will include men aged 18-40 years presenting with scrotal pain or symptoms suggestive of torsion. Patients with scrotal trauma, symptom duration over one week, previous testicular surgery, or inability to give informed consent in Swedish will be excluded. Participants' clinical findings will be recorded on a standardized form, and the TWIST score will be calculated. Management will follow standard clinical practice independently of the study. Primary outcome is the diagnostic accuracy of the TWIST score to rule out testicular torsion in low-risk patients (TWIST 0-2). Secondary outcomes include diagnosis of torsion within 30 days, time to surgery, patient-reported pain, number of Doppler ultrasounds performed, and the potential reduction in unnecessary imaging. The study will be conducted at multiple Swedish sites, including Linköping University Hospital, under oversight by the Swedish Ethical Review Authority (Etikprövningsmyndigheten, decision number 2025-07400-01). The results aim to inform clinical practice by providing a validated decision-support tool for adult patients with suspected testicular torsion, potentially improving patient outcomes and resource utilization.

Deep Learning-Assisted Ultrasonic Diagnosis and Localization of Testicular Appendix Torsion

Ultrasound data were both retrospectively and prospectively collected from the primary center and six other sub-centers. Combined with clinical diagnostic outcomes, the data labeling was completed by physicians with extensive clinical experience. In this study, ConvNeXtV2 was used as the classification network and YOLOv12 was adopted as the detection network.The retrospective dataset from the primary center was split into training, validation, and test subsets, on which the model was trained, validated, and tested respectively; additional validation was conducted on both retrospective and prospective datasets from the primary center and sub-centers.Meanwhile, four physicians were assigned to interpret the ultrasound data from the retrospective and prospective datasets from the primary center and sub-centers using two diagnostic methods-independent diagnosis and artificial intelligence (AI)-assisted diagnosis-and the diagnostic accuracy of these two approaches was further compared.By collecting and learning the treatment methods of patients in the primary center training set, predicting the treatment methods of patients in the sub-center datasets, and comparing the proportion of surgeries predicted by AI with the actual proportion of surgeries, the efficacy of the model was verified.

Testicular Torsion Evaluation by ultraSonography Technic Imaging

The goal of this observational study is to assess the diagnostic concordance between testicular Doppler ultrasound of the spermatic cord vessels performed by an emergency physician and the diagnosis of testicular torsion made by the urologist during an exploration in the operating room (Gold standard) in men patients between 16 to 70 years old with suspicion of testicular torsion. Participants will receive ultrasound performed by emergency physician during their visit to the emergency department. Results of this exam will be compare to gold standard. If the results are consistent, the investigators will have demonstrated the value of integrating ultrasound by the emergency physician into the management of testicular torsion.

Prospective Observational Study on SEBBIN Silicone Gel-filled Testicular Implants

To analyze the short and long term postoperative clinical outcome and patient satisfaction of silicone gel-filled testicular implants.