Investigation of Clinical and Hematological Parameters Predicting Organ Loss in Testicular Torsion

Abstract

Objective: In this study, we aimed to determine clinical and hematological parameters that may predict testicular viability or testicular loss in patients diagnosed with testicular torsion and undergoing scrotal exploration. Materials and Methods: Our study included 98 patients aged 1-25 years diagnosed with testicular torsion. Two groups were formed: the testicular salvage group and the unsuccessful testicular salvage group. Demographic, clinical, and hematological parameters of the two groups were compared. Results: While 52 patients were considered successful testicular salvage, 46 patients were grouped as unsuccessful. Symptom duration and torsion degree were significantly higher in the unsuccessful testicular salvage group than in the successful testicular salvage group (p<0.001, respectively). White blood cell, neutrophil, monocyte, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI) values were significantly higher in the unsuccessful testicular salvage group (p=0.001, p<0.001, p=0.016, p=0.002, p=0.012, p=0.001, p=0.001, p<0.001, and p<0.001, respectively). The most important predictors for successful testicular salvage were symptom duration and degree of torsion. In the successful salvage of testicular torsion, the threshold for symptom duration was established at 9 hours, while the maximum torsion degree tolerated was set at 270 degrees. Furthermore, 2.21x10(3)/mu L for SIRI and 635.59x10(6)/mu L-2 for AISI were determined as the limit values predicting organ loss. Conclusion: In our study, we found that the most important parameters in predicting organ loss in testicular torsion were the degree of torsion and symptom duration. Hematological parameters in testicular torsion patients may help predict the need for scrotal exploration and potential outcomes such as orchiectomy or testicular atrophy.