Mean platelet volume is the most valuable hematologic parameter in differentiating testicular torsion from epididymitis within the golden time

Abstract

Background: We aimed to assess the diagnostic value of hematologic parameters in the differential diagnosis of testicular torsion and epididymitis within and after the golden time. Methods:We retrospectively reviewed the records of 250 patients aged <25 years who were diagnosed with epididymitis (n=119) or testicular torsion (n=131). The characteristics and hematologic parameters of patients in the two groups were analyzed. Receiver operating characteristic (ROC) curves were used to assess the validity of hematologic parameters as differential diagnostic tools with respect to the golden time (defined as 6 h of symptom duration). Further, we evaluated the predictive factors associated with orchiectomy in patients with testicular torsion.Results: The mean patient age was 14.4 years. Among patients with testicular torsion, 91.40% (53 of 58) underwent detorsion and orchiopexy within the golden time, whereas only 27.40% (20 of 73) of the affected testes were preserved after the golden time. Within the golden time, mean platelet volume (MPV) seemed to be the most valuable hematologic parameter [area under the curve (AUC) 0.855, 95% confidence interval (CI): 0.778-0.932]. In a multivariate analysis, symptom duration (symptoms beyond the golden time) was associated with orchiectomy in patients with testicular torsion.Conclusions: MPV showed the greatest hematologic value in the early stage of testicular torsion and epididymitis, suggesting its potential use for the differential diagnosis of these two conditions within the golden time.

New insights about prognosis of Spermatic Cord Torsion

“…6 Lee et al evalulated Mean Platelet Volume (MPV) increase as an index of eminent testicular atrophy of the torsed testis (Sensitivity 81.8%, specificity 70.6%). 7 Caldamone et al retrospectively studied 150 boys with acute scrotum. 30/150 had SCT.…”

“…evalulated Mean Platelet Volume (MPV) increase as an index of eminent testicular atrophy of the torsed testis (Sensitivity 81.8%, specificity 70.6%). 7…”

Is it time to also use hematologic parameters for the diagnosis and prognosis of testicular torsion?

“…In the article, Lee and collaborators ( 1 ) examine the role that hematologic parameters obtained from complete blood counts (CBCs) may play in the early diagnosis of testicular torsion (torsion) versus acute epididymo-orchitis (epididymitis) in acute scrotum patients. They retrospectively compared hemoglobin concentration, mean corpuscular volume (MCV), white blood cell (WBC) count, platelet, neutrophil, lymphocyte and monocyte counts (PLC, NC, LC, MC), platelet distribution width (PDW), mean platelet volume (MPV), neutrophil ratio, lymphocyte ratio, monocyte ratio, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) between 131 patients with torsion and 119 with epididymitis both before and after 6 hours of symptoms.…”