Can haematologic parameters be used for differential diagnosis of testicular torsion and epididymitis?

Abstract

A differential diagnosis of testicular torsion and epididymitis has serious importance for testicular health. In emergency conditions, if testicular torsion goes unnoticed and epididymo-orchitis is diagnosed, organ loss may occur. This study aimed to evaluate the usefulness of haematologic parameters for the diagnosis of both testicular torsion and epididymo-orchitis and for differential diagnosis of these two diseases. Patients were divided into three groups as those undergoing surgery for testicular torsion, those receiving medical treatment for epididymitis and a healthy control group. All patients had complete blood counts taken with determinations of mean platelet volume (MPV), platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR) and leucocyte counts. These were then compared between groups. Leucocyte, MPV and NLR values were higher in both the epididymitis and torsion groups compared to the controls (p < .001). Platelet counts and PLR were significantly higher in the epididymitis group compared to the other two groups (p < .001). Leucocyte, MPV and NLR values may be used in the diagnosis of epididymitis and testicular torsion. Platelet counts and PLR appear to be useful in differentiating epididymitis from testicular torsion. However, there is a need for prospective studies with larger numbers of patients.

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

“…According to the inclusive and exclusive criteria, six were excluded for various reasons after reading the full texts. Ultimately, a total of five case–control studies remained in the final analyses (Bitkin et al, ; Cicek et al, ; Güneş et al, ; Peretti et al, ; Yucel & Ozlem Ilbey, ). The flow chart of literature retrieval and selection process was outlined in Figure .…”

“…Recently, some investigators reported that haematologic parameters at admission (including mean platelet volume [MPV], platelet lymphocyte ratio [PLR], neutrophil–lymphocyte ratio [NLR], platelet [PLT] and leucocyte) are different between TT and epididymo‐orchitis patients. Therefore, these haematologic parameters may have potential as diagnostic markers for TT (Bitkin et al, ; Cicek, Togan, Akbaba, Narci, & Aygun, ; Güneş et al, ; Peretti et al, ; Yucel & Ozlem Ilbey, ). Of these studies, controversy and inconformity still remained and most of them recruited a limited sample capacity, which is insufficient to get a firm conclusion.…”

The role of inflammatory parameters (neutrophil‐to‐lymphocyte ratio, platelet‐to‐lymphocyte ratio, and monocyte‐to‐eosinophil ratio) in patients with Peyronie's disease

“…Likewise, Bitkin et al . reported that leukocyte, MPV, and NLR might be used in the diagnosis of epididymitis and testicular torsion and platelet counts and PLR might be useful to differentiate epididymitis from testicular torsion (Bitkin et al ., ). Ventimiglia et al .…”

Can haematologic parameters be used to predict testicular viability in testicular torsion?

“…In contrast, Güneş et al, () reported that MPV did not have diagnostic ability for TT, but NLR did, by comparing 75 TT patients with 56 age‐matched healthy subjects. Bitkin et al, () found that MPV was increased in children with testicular torsion and epididymitis, but it was not different between the two groups. Nevertheless, they suggested that routine blood tests provide a rapid and inexpensive platform of diagnosing TT.…”

“…Numerous studies have reported that haematologic parameters can be used for the differential diagnosis of TT (Bitkin et al, ; Cicek, Togan, Akbaba, Narci, & Aygun, ). But to our knowledge, only one study by Jang et al have reported the association between haematologic parameters and the testicular salvage rate.…”