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Funding informationThe Beijing hospital authority "dengfeng" talent training plan (DFL20151102); The Beijing hospital authority "yangfan plan": pediatric urology (ZYLX201709). AbstractThe purpose of this study was to evaluate the predictive value of haematologic parameters for testicular survival in torsion. Children with testicular torsion (TT) treated in Beijing Children's Hospital from January 2006 to December 2018 were enrolled in this study. Patient data collected in this study included age, symptom duration, preoperative preparation time, cryptorchidism testicular torsion or not, spermatic cord torsion degree, orchiectomy/orchiopexy, testicular volume 3 months after operation by ultrasound in orchiopexy patients and haematologic parameters. The orchiopexy group comprised of 54 patients with a mean age of 135.6 ± 43.73 months, and the orchiectomy group included 58 patients with a mean age of 119.36 ± 60.82 months. The multivariate analysis showed that symptom duration (Odds Ratio = 1.11, p < 0.001), spermatic cord torsion degree (Odds Ratio = 1.006, p = 0.002) and mean platelet volume (MPV; Odds Ratio = 3.697, p = 0.044) were significant predictors of orchiectomy.The cut-off value for MPV during window time for orchiectomy was 10.55 fl (10 −9 L) and provided a sensitivity of 47.8% and a specificity of 92.6%. This study found that symptom duration, spermatic cord torsion degree and MPV could be indicators of testicular viability in testicular torsion. MPV can provide valuable information before operation which can guide doctors and family members of the patients to select the appropriate treatment. K E Y W O R D Smean platelet volume, orchiectomy, testicular torsion

| INTRODUC TI ONTesticular torsion, a urological emergency, is the main cause of paediatric acute scrotal pain. The main manifestation of testicular torsion is the decrease of testicular blood flow, which is caused by the spermatic cord twisting on itself around its longitudinal axis. The incidence of males under 25 years old who suffer from testicular torsion is 1:4,000 (Barada, Weingarten, & Cromie, 1989;Pogorelic et al., 2016).Most studies that have been conducted have focused on identifying potential indicators that predict testicular activity during surgery, such as symptom duration and the degree of spermatic cord torsion; however, only a few focused on whether testicular atrophy occurred in children who undergo orchiopexy. A study showed that testicular atrophy occurs in half of the number of children with orchiopexy (Lian, Ong, Chiang, Rai, & Nah, 2016).In our previous studies, we found that the duration of onset, the degree of spermatic cord torsion and the mean platelet volume (MPV) could predict intra-operative testicular activity, but our study did not reveal the long-term prognosis of these children. In this study, we continue to follow up these patients who underwent orchiopexies in order to observe whether testicular atrophy had occurred. Furthermore, we aim to identify any influencing factors regarding atrophy. | MATERIAL S AND ME THODSChildren with testicular torsion who underwent orchiopexy and who were consecutively treated in Beijing Children's Hospital from January 2006 to December 2018 were enrolled in this study.Surgery was performed by paediatric urologists who have more than 5 years of clinical experience. After the twisted spermatic AbstractThe purpose of this study was to follow up patients who underwent testicular torsion orchiopexies in order to observe whether testicular atrophy had occurred and to identify any influencing factors regarding atrophy. Patient data collected in this study included age, symptom duration, pre-operative preparation time, cryptorchidism testicular torsion, spermatic cord torsion degree, ultrasound findings at least 6 months after orchiopexy, testicular atrophy, mean platelet volume (MPV), address and medical insurance. Twenty-nine patients with a mean age of 147 (126.5-163) months involved in our study. The duration of follow-up ranged from 6 to 33 months with a median follow-up duration of 12 (8.5-21) months. Only MPV was significantly different between the atrophy group and nonatrophic group (p = .022) and the receiver operating characteristic (ROC) curve revealed that the cut-off value for MPV atrophy was 9.9 fl, with a sensitivity of 81.8% and a specificity of 70.6%. In conclusion, we found that 41.4% patients eventually experienced testicular atrophy after performing the testicular salvage procedure. MPV might be used as an indicator of testicular atrophy after an operation; however, the accuracy of MPV needs to be confirmed using significant follow-up prospective studies. K E Y W O R D SMPV, orchiopexy, tesiticular torsion, testicular atrophy