Should haematological inflammatory markers be included as an adjuvant in the differential diagnosis of acute scrotal pathologies?

Yılmaz, Mehmet; Şahin, Yusuf; Hacıbey, İbrahim; Özkuvancı, Ünsal; Suzan, S; Müslümanoğlu, Ahmet Yaser

doi:10.1111/and.14374

Cited by 3 publications

(4 citation statements)

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“…22 Yilmaz et al found that monocyte count was the only significant variable of testicular viability (OR, 0.046; 95% CI, 0.006-0.366; p = 0.004) in patients with testicular torsion using multivariate analysis. 23 The authors noted that the monocyte count in patients with testicular torsion might indicate testicular viability. In our study, monocyte count was identified as an independent risk factor for testicular salvage during testicular torsion using multivariate logistic regression analysis (OR, 0.012; 95% CI, 0.000-0.755; p = 0.036).…”

Section: Resultsmentioning

confidence: 99%

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A nomogram for predicting risk factors of testicular salvage after testicular torsion in children

Chen,

Huang,

et al. 2024

Int J of Urology

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ObjectivesThis study aimed to establish a nomogram for predicting the probability of testicular salvage after testicular torsion in children.MethodsWe retrospectively collected data of children with testicular torsion who were treated at Shenzhen Children's Hospital between September 2005 and August 2022. Of the training cohort, 113 patients who underwent orchiectomy and five with testicular atrophy after orchiopexy were included in the failed testicular salvage group. Additionally, 37 patients who underwent orchiopexy without postoperative testicular atrophy were included in the successful testicular salvage group. The predictive factors affecting testicular salvage were determined using univariate and multivariate logistic regression analyses; a nomogram was constructed. The nomogram was verified using data from the validation group.ResultsUsing multivariate logistic regression analysis, the independent risk factors of testicular salvage after testicular torsion were symptom duration (p = 0.034), intratesticular blood flow (p = 0.003), spermatic cord torsion degree (p = 0.037), and monocyte count (odds ratio: 0.012, p = 0.036). A nomogram was established based on these four risk factors. In the training cohort, the area under the receiver operating characteristic curve was 0.969. The area under the receiver operating characteristic curve of the verification cohort was 0.965, indicating good discrimination ability of the nomogram. Increased symptom duration without intratesticular blood flow increased the monocyte count and spermatic cord torsion degree and decreased the success rate of testicular salvage.ConclusionThis prediction model could obtain the corresponding probability of testicular salvage according to the clinical characteristics of different patients with testicular torsion, providing reference for clinicians and parents.

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Section: Resultsmentioning

confidence: 99%

“…Yilmaz et al. found that monocyte count was the only significant variable of testicular viability (OR, 0.046; 95% CI, 0.006–0.366; p = 0.004) in patients with testicular torsion using multivariate analysis 23 . The authors noted that the monocyte count in patients with testicular torsion might indicate testicular viability.…”

Section: Discussionmentioning

confidence: 99%

A nomogram for predicting risk factors of testicular salvage after testicular torsion in children

Chen,

Huang,

et al. 2024

Int J of Urology

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“…Through multivariate logistic regression analysis, Yilmaz et al observed that monocyte count was the only significant variable of testicular viability in patients with testicular torsion (OR = 0.046, 95%CI: 0.006–0.366, P < 0.004) and that monocyte count could predict testicular salvage in patients with testicular torsion ( 19 ). Merder et al ( 7 ) retrospectively analyzed the data of 88 patients with testicular torsion (61 cases of orchiopexy and 27 cases of orchiectomy).…”

Section: Discussionmentioning

confidence: 99%

Predictive value of hematological parameters in testicular salvage: A 12-year retrospective review

et al. 2022

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PurposeThis study aimed to evaluate the predictive value of preoperative hematological parameters for testicular salvage in patients with testicular torsion.MethodsClinical data of patients with testicular torsion treated at Shenzhen Children's Hospital from January 2010 to December 2021 were analyzed retrospectively. The data collected included age, symptom duration, degree of spermatic cord torsion, the surgical approach adopted, hematological parameters, and ultrasound results during postoperative follow-up.ResultsThe study participants were classified into three groups as follows: the successful testicular salvage group (n = 43), failed testicular salvage group (n = 124), and control group (n = 100). Univariate analysis showed that testicular salvage was related to patient age, duration of symptoms, spermatic cord torsion degree, white blood cell count, lymphocyte count, monocyte count, platelet-lymphocyte ratio, and neutrophil-lymphocyte ratio. However, multivariate analysis revealed that symptom duration (OR = 0.948, P < 0.001), degree of spermatic cord torsion (OR = 0.994, P < 0.001), and monocyte count (OR = 0.020, P = 0.011) were independent risk factors for testicular torsion salvage. The monocyte count in the failed salvage group was significantly higher than in the successful salvage and control groups (P < 0.01).ConclusionMonocyte count is an independent predictor of testicular salvage. Therefore, clinicians can predict the success rate of testicular salvage in patients with testicular torsion based on the monocyte count.

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“…Yilmaz et al. reported that monocyte counts predict testicular preservation, 3 but evidence regarding blood markers is still lacking and controversial.…”

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Editorial Comment on A nomogram for predicting risk factors of testicular salvage after testicular torsion in children

Takeshita

2024

Int J of Urology

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Testicular torsion is a disease that causes testicular ischemia and, if the torsion is not resolved within a certain period of time, irreversible testicular necrosis. The most important factors that determine testicular prognosis are thought to be the torsion angle and ischemia time, and if the testicular torsion angle is >360°and the ischemia time exceeds 24 h, it is said that all testes become necrotic.Other predictors of testicular prognosis have also been investigated, including ultrasound findings and several blood inflammatory markers. As a marker for predicting testicular prognosis, He et al. reported mean platelet volume (MPV) 1 and Jang et al. reported neutrophil-lymphocyte ratio (NLR). 2 Yilmaz et al. reported that monocyte counts predict testicular preservation, 3 but evidence regarding blood markers is still lacking and controversial.In this study, Chen et al performed a multivariate analysis using ultrasound findings and blood markers such as NLR, MPV, and monocyte count, in addition to traditional risk factors such as ischemia time and torsion angle. 4 They discovered that monocytes were an independent risk factor and created a nomogram that included this. This result reinforced previous evidence of monocyte as a blood marker. Monocytes are a largest type of white blood cell, and when tissue injury or infection occurs, monocytes are rapidly recruited to tissues where they differentiate into tissue macrophages or dendritic cells. Several reports have shown that monocyte count was a better biomarker of cardiovascular disease than other inflammatory markers such as C-reactive protein. 5 Considering the pathogenesis of testicular ischemia, which has similarities with cardiovascular disease, monocyte counts may be a promising marker.The data from this study are not without question. This study was conducted in Shenzhen, a rapidly developing city in China, using a population with a testicular preservation rate of only 28% (58/203). 4 There may be differences in the time it takes to visit the hospital and the method of ultrasound evaluation compared with our daily clinical practice. It is unclear whether the monogram using monocyte count can be applied in populations with higher testicular preservation rates. In the future, further validation using data from other countries is required.

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Should haematological inflammatory markers be included as an adjuvant in the differential diagnosis of acute scrotal pathologies?

Cited by 3 publications

References 32 publications

A nomogram for predicting risk factors of testicular salvage after testicular torsion in children

A nomogram for predicting risk factors of testicular salvage after testicular torsion in children

Predictive value of hematological parameters in testicular salvage: A 12-year retrospective review

Editorial Comment on A nomogram for predicting risk factors of testicular salvage after testicular torsion in children

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