Are Haematological Parameters Reliable for Differential Diagnosis of Testicular Torsion and Epididymitis?

Objective: Acute scrotum is a urological emergency that can result in loss of the testis if the differential diagnosis is not made immediately. Testicular torsion (TT) and epididymo-orchitis (EO) are the two most common causes of acute scrotum. Our aim was to evaluate the utility of haematological parameters for the diagnosis of both TT and EO and for differential diagnosis of these two conditions. Materials and Methods: Data of 98 patients who applied because of acute scrotum between January 2007 and April 2018 were retrospectively analyzed. The patients were divided into three groups: those with TT diagnosis, with EO diagnosis and controls with the diagnosis of other noninflammatory conditions. Demographic data, complete blood count and biochemical parameters at admission were recorded. Values for these parameters along with platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and platelet mass index (PMI) were examined for all groups. The specificity, sensitivity and positive and negative predictive value of parameters that were statistically significant were compared between the groups. Results: Of the 98 patients included in this study, 32 were in the first group, 41 were in the second and 25 were in the third group. The mean neutrophil count in the TT, EO and control groups was 8.7, 7.2 and 5.4, respectively (p=0.001). The mean leukocyte count was 11.8, 10.8 and 8.3 in the TT, EO and control groups, respectively (p=0.003). There was no statistically significant difference in mean lymphocyte count, mean platelet count and PLR, NLR, and PMI between the groups. Conclusion: Although, these tests were insufficient to differentiate TT from EO, we think that they may narrow the indications for emergent exploration for acute scrotum.

Hematolojik Parametreler Testiküler Torsiyon ve Epididimit Ayırıcı Tanısında Güvenilir Midir?

Amaç: Akut skrotum, ayırıcı tanı hemen yapılmazsa testis kaybına neden olabilecek ürolojik bir acil durumdur. Testiküler torsiyon (TT) ve epididimoorşit (EO) akut skrotumun en yaygın iki nedenidir. Hematolojik parametrelerin hem TT hem de EO tanısı ve bu iki hastalığın ayırıcı tanısı için yararlılığını değerlendirmekti. Gereç ve Yöntem: Akut skrotum nedeniyle Ocak 2007-Nisan 2018 tarihleri arasında başvuran 98 hastanın verileri retrospektif olarak incelendi. Hastalar üç gruba ayrıldı. İlk grup TT tanısı, ikinci grup EO tanısı olan ve üçüncü grup enflamatuvar olmayan nedenlerden oluşan kontrol grubu. Tüm grupların giriş sırasındaki demografik veriler, tam kan sayımı ve biyokimyasal parametreler kaydedildi. Bu parametreler içinde platelet / lenfosit oranı (PLR), nötrofil / lenfosit oranı (NLR) ve trombosit kitle indeksi (PMI) değerlendirildi. Özgüllük, duyarlılık, pozitif ve negatif prediktif değerler, istatistiksel olarak anlamlı olan parametreler için gruplar arasında karşılaştırıldı. Bulgular: Çalışmaya alınan doksan sekiz hastanın 32’si birinci, 41’i ikinci, 25’i üçüncü gruptaydı. Ortalama nötrofil değerleri TT grubunda 8,7, EO grubunda 7,2 ve kontrol grubunda 5,4 idi (p=0,001). Ortalama lökosit değerleri TT grubunda 11,8, EO grubunda 10,8 ve kontrol grubunda 8,3 idi (p=0,003). Gruplar arasında ortalama lenfosit sayısı, ortalama trombosit sayısı ve PLR, NLR, PMI açısından istatistiksel fark yoktu. Sonuç: Her ne kadar bu testler TT ve EO’yu ayırt etmek için yetersiz olsa da, akut skrotum için acil eksplorasyon endikasyonlarını daraltabileceğini düşünmekteyiz.

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