Objective: In this study, we aimed to investi- gate the benefit of hematological results in deter- mining the differential diagnosis between testicu- lar torsion (TT) and epididymo-orchitis (EO) in patients presenting with acute scrotum, and to de- termine its predictive value for the diagnosis of TT. Material and Methods: We retrospectively ana- lyzed 98 patients who applied to our institute’s urology clinics or emergency service with complaints of acute scrotum. Thirty-two patients who underwent orchiec- tomy or detorsion due to TT and 48 patients with EO were included in the study. The control group consist- ed of 80 healthy men. Groups were compared in terms of hematological parameters such as age, white blood cell (WBC), mean platelet volume (MPV), neutrophil/ lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), and platelet/lymphocyte ratio (PLR).
Results: WBC, MPV and NLR were found to be statistically significant in distinguishing TT group from other groups, respectively; (AUC = 0.732, 95% CI: 0.647-0.816 and p<0.001), (AUC = 0.720, 95%CI: 0.615-0.825 and p<0.001), (AUC = 0.629, 95% CI: 0.519-0.739 and p=0.024). In the comparison between the detorsion and orchiectomy subgroups within the TT group, the first hadastatistically lower monocyte count (p=0.005) and MLR level (p=0.038). Conclusion: Hematological parameters; that is, WBC, MPV and NLR, which can be easily determined from complete blood count analysis, had high sensitivi- ty and specificity similar to Doppler ultrasonography to predict TT. In addition, we think that monocyte and MLR levels may be beneficial in patients who have difficulty in the decision of orchiectomy or detorsion in TT surgery.
Keywords: acute scrotum; epididymo-orchitis; mean platelet volume; neutrophil/lymphocyte ratio; testicular torsion.
ABSTRACT
Objective: In this study, we aimed to investi- gate the benefit of hematological results in deter- mining the differential diagnosis between testicu- lar torsion (TT) and epididymo-orchitis (EO) in patients presenting with acute scrotum, and to de- termine its predictive value for the diagnosis of TT. Material and Methods: We retrospectively ana- lyzed 98 patients who applied to our institute’s urology clinics or emergency service with complaints of acute scrotum. Thirty-two patients who underwent orchiec- tomy or detorsion due to TT and 48 patients with EO were included in the study. The control group consist- ed of 80 healthy men. Groups were compared in terms of hematological parameters such as age, white blood cell (WBC), mean platelet volume (MPV), neutrophil/ lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), and platelet/lymphocyte ratio (PLR).
Results: WBC, MPV and NLR were found to be statistically significant in distinguishing TT group from other groups, respectively; (AUC = 0.732, 95% CI: 0.647-0.816 and p<0.001), (AUC = 0.720, 95%CI: 0.615-0.825 and p<0.001), (AUC = 0.629, 95% CI: 0.519-0.739 and p=0.024). In the comparison between the detorsion and orchiectomy subgroups within the TT group, the first hadastatistically lower monocyte count (p=0.005) and MLR level (p=0.038). Conclusion: Hematological parameters; that is, WBC, MPV and NLR, which can be easily determined from complete blood count analysis, had high sensitivi- ty and specificity similar to Doppler ultrasonography to predict TT. In addition, we think that monocyte and MLR levels may be beneficial in patients who have difficulty in the decision of orchiectomy or detorsion in TT surgery.
Keywords: acute scrotum; epididymo-orchitis; mean platelet volume; neutrophil/lymphocyte ratio; testicular torsion.