ACR Appropriateness Criteria® Acute Onset of Scrotal Pain-Without Trauma, Without Antecedent Mass

Imaging, Expert Panel on Urological; Wang, Carolyn L.; Aryal, Barun Babu; Oto, Aytekin; Allen, Brian C.; Akın, Oğuz; Alexander, Lauren; Bardo, Dianna M. E.; Chong, Jaron; Froemming, Adam T.; Fulgham, Pat F.; Heller, Matthew T.; Maranchie, Jodi K.; Mody, Rekha N.; Patel, Bhavik N.; Schieda, Nicola; Türkbey, İsmail Barış; Venkatesan, Aradhana M.; Yoo, Don C.; Lockhart, Mark E.

doi:10.1016/j.jacr.2019.02.016

Cited by 17 publications

(9 citation statements)

References 38 publications

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“…Acute scrotal pain is one of the most common acute symptoms in urology practice. TT and epididymo‐orchitis are two common causes of acute scrotal pain (Wang et al, ). Due to high TT misdiagnosis rate of 10%–32% and golden rescue time of 6 hr, the orchiectomy rate has reached 25%–70% (Lee et al, ; Li, Gao, Yin, & Yang, ; Romao, Anderson, MacLellan, & Anderson, ; Sharp, Kieran, & Arlen, ; Watkin, Reiger, & Moisey, ).…”

Section: Discussionmentioning

confidence: 99%

Predictive value of haematologic parameters in diagnosis of testicular torsion: Evidence from a systematic review and meta‐analysis

et al. 2019

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To compare the difference of mean platelet volume (MPV), platelet lymphocyte ratio (PLR), neutrophil–lymphocyte ratio (NLR), platelet (PLT) and leucocyte between testicular torsion (TT), epididymo‐orchitis and healthy controls and further evaluate predictive values of these haematologic parameters in diagnosis and the differential diagnosis of TT. Databases were systematically retrieved, and reference search was also conducted manually. We applied Stata software 12.0 to perform a systematic review and meta‐analysis. Ultimately, five case–control studies with 672 participants were recruited for analyses. Pooled analyses indicated that TT patients had lower NLR (WMD = −1.66, 95% CI = −3.25 to −0.06) and PLT (WMD = −27.39, 95% CI = −48.03 to −6.75) compared to epididymo‐orchitis patients. In the meantime, TT patients had higher NLR and leucocyte than healthy controls (p < .05). That is to say, when a man develops TT, his NLR and leucocyte will rise up but his NLR will not reach the level of epididymo‐orchitis. To sum up, NLR, PLT and leucocyte were vital factors for TT diagnosis. Leucocyte is an useful parameter for diagnosing both TT and epididymo‐orchitis, but it cannot be used in differentiating the two diseases. NLR is beneficial parameter for differential diagnosis between TT and epididymo‐orchitis. PLT can also be utilised in differential diagnosis among young patients.

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Section: Discussionmentioning

confidence: 99%

Predictive value of haematologic parameters in diagnosis of testicular torsion: Evidence from a systematic review and meta‐analysis

et al. 2019

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“…The predictive and prognostic significance of the change in RDW due to factors like inflammation, hypoxia–oxidative stress and sympathetic discharge has been shown in acute coronary syndrome (Ryu et al, 2020; Su et al, 2017). Increased RDW has been associated with impaired microcirculation due to the decrease in red blood cell deformability and decreased oxygenation at tissue level (Gunes et al, 2015; Wang et al, 2019).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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The aim of this study was to determine discriminative role of haematological inflammatories between acute scrotal pathologies and malignancies. In addition, it was aimed to search for a predictive marker of testicular survival in the TT group. Medical data of 141 patients with acute scrotal pathology and 63 TTm patients who presented to our clinic between January 2015 and July 2019 were retrospectively reviewed and compared in terms of haematological values and demographic parameters following the inclusion of 92 healthy controls. In the TTm group, NLR was the discriminative parameter with a median of 2.42 (0.25–8.42), whereas discriminative median values of MCV for TT and CRP for EO were 83.65 (56.9–98.16) and 59.5 (2.9–337) respectively. NLR, PLR, MER and RDW values were statistically lower in the control group compared to the patients groups. In TT subgroup analysis, monocyte count, MER and CRP were found to be statistically higher in the orchiectomy group, while multivariate logistic regression analysis performed for testicular viability revealed monocyte count to be the only significant variable (Odds Ratio [95% Confidence Interval] = 0.046 (0.006–0.366), p<0.004). While our study demonstrated both diagnostic and discriminative values of haematological parameters, it also showed that monocyte count could predict testicular salvage in TT patients. However, further prospective studies are required.

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“…The aforementioned documents mainly focused on the indications and methodology of scrotal US. From 2000, the American College of Radiology (ACR) has published several documents, including the 2019 updated version 23 on CDUS appropriateness criteria in evaluating acute scrotum. In 2021, the American Urological Association (AUA) updated urologic (including scrotal) trauma guidelines, 24 and more recently the European Society of Urogenital Radiology (ESUR) published a more accurate position statement on the appropriate use of multiparametric US, along with other imaging modalities, in the evaluation of scrotal trauma 25 .…”

Section: Guidelines and Recommendationsmentioning

confidence: 99%

Historical trends for the standards in scrotal ultrasonography: What was, what is and what will be normal

2021

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Background: Ultrasonography is the gold standard imaging method for scrotal investigation. Colour Doppler ultrasonography, contrast-enhanced ultrasonography and sonoelastography allow sonographers to assess size, echotexture, vascular features and stiffness of the scrotal organs and abnormalities. Scrotal ultrasonography has been used to investigate male reproductive health, scrotal pain, masses and trauma. However, ultrasonography thresholds/classifications used to distinguish normal and pathologic features of the scrotal organs have changed over time, and have not yet been fully standardized. Objectives: To evaluate historical trends for the standards in scrotal ultrasonography:what was, what is and what will be normal.Methods: An extensive Medline search was performed identifying the most relevant studies in the English language from inception to date. Results:We provide here (i) a brief overview of the history of ultrasonography, (ii) current indications for scrotal ultrasonography and (iii) previous and current normal values, cut-offs and classifications of the main colour-Doppler ultrasonography parameters/characteristics of the scrotal organs, as derived from recent guidelines and evidence-based studies. In addition, we report recommendations and the clinical utility of contrast-enhanced ultrasonography and sonoelastography. Finally, we discuss critical issues needing further evidence and future directions to fill in the current gaps.Discussion: Several studies on scrotal ultrasonography are available. However, guidelines/recommendations dealing with specific ultrasonography applications have been published only in recent years. More recently, the European Academy of Andrology published evidence-based scrotal colour-Doppler ultrasonography reference ranges/normative parameters derived from a cohort of healthy, fertile men. In addition, a standardization of the methodology to evaluate qualitative and quantitative colour-Doppler ultrasonography parameters was reported. Other international societies reported indications, methodological standards, clinical utility and limitations of contrast-enhanced ultrasonography and sonoelastography.

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ACR Appropriateness Criteria® Acute Onset of Scrotal Pain-Without Trauma, Without Antecedent Mass

Cited by 17 publications

References 38 publications

Predictive value of haematologic parameters in diagnosis of testicular torsion: Evidence from a systematic review and meta‐analysis

Predictive value of haematologic parameters in diagnosis of testicular torsion: Evidence from a systematic review and meta‐analysis

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

Historical trends for the standards in scrotal ultrasonography: What was, what is and what will be normal

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