Complete Blood Count Markers and C-Reactive Protein as Predictors of Testicular Viability in the Event of Testicular Torsion in Adults

Urol Int. 2023;107(8):801-806. doi: 10.1159/000531145. Epub 2023 Jul 7.

Abstract

Introduction: The association between blood markers and testicular viability after testicular torsion (TT) is not well known. We evaluated the role of complete blood count markers and C-reactive protein (CRP) in predicting testicular viability after TT.

Methods: Fifty men, ≥18 years of age, operated for TT between the years 2015-2020 were enrolled. Blood markers including neutrophil-, lymphocyte-, and platelet count, and CRP were obtained. Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were calculated. The study outcome was testicular salvage.

Results: Median age was 23 years (interquartile range [IQR]: 21, 31). Median duration of torsion was 10 h (IQR: 6, 42). Sonographic texture of the testis was homogenous in 27 (56%) patients and heterogenous in 21 (44%). During scrotal exploration, 36 patients (72%) underwent orchiopexy and 14 (28%) underwent orchiectomy. Patients who underwent orchiopexy were younger (22 years vs. 31 years, p = 0.009), had a shorter duration of torsion (median 8 h vs. 48 h, p < 0.001), and a homogenous texture on scrotal ultrasound (76.5 vs. 7.1%, p < 0.001). Median NLR, PLR, and CRP were higher among patients who underwent orchiectomy; however, these differences did not reach statistical significance. Patients with heterogenous echotexture were significantly more likely to undergo orchiectomy (odds ratio = 42, 95% confidence interval: 7, 831, adjusted p value = 0.009).

Conclusions: We found no association between blood-based biomarkers and testicular viability after TT; however, testicular echotexture significantly predicted outcome.

Keywords: C-reactive protein; Neutrophil-lymphocyte ratio; Orchiectomy; Platelet-lymphocyte ratio; Testicular torsion.

MeSH terms

  • Adult
  • C-Reactive Protein
  • Humans
  • Male
  • Orchiectomy
  • Platelet Count
  • Retrospective Studies
  • Spermatic Cord Torsion* / surgery
  • Testis* / diagnostic imaging
  • Testis* / surgery
  • Young Adult

Substances

  • C-Reactive Protein

Grants and funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.