Akut skrotumda testis torsiyonu ve epididimo-orşit arasındaki hematolojik belirteçlerin karşılaştırılması

Amaç: Bu çalışmada, akut skrotum ile başvuran hastalarda testis torsiyonu (TT) ve epididimo-orşit (EO) arasındaki ayırıcı tanıyı belirlemede hematolojik sonuçların yararını araştırmayı ve TT tanısı için prediktif değerini belirlemeyi amaçladık.Gereç ve Yöntemler: Akut skrotuma bağlı şikayetler ile enstitümüzün üroloji kliniklerine veya acil servisine başvuran 98 olguyu retrospektif olarak inceledik. Çalışmaya TT›ye bağlı orşiektomi veya detorsiyon uygulanan 32 hasta ve EO’lu 48 hasta alındı. Kontrol grubu 80 sağlıklı erkekten oluşuyordu. Gruplar yaş, beyaz kan hücresi (WBC), ortalama trombosit hacmi (MPV), nötrofil/lenfosit oranı (NLR), monosit/lenfosit oranı (MLR) ve trombosit/lenfosit oranı (PLR) gibi hematolojik parametreler açısından karşılaştırıldı.Bulgular: TT grubunu diğer gruplardan ayırt etmede WBC, MPV ve NLR istatistiksel olarak anlamlı bulundu, sırasıyla; (AUC = 0.732, %95 CI: 0.647-0.816 ve p <0.001), (AUC = 0.720, %95 CI: 0.615-0.825 ve p <0.001), (AUC = 0.629, %95 CI: 0.519-0.739 ve p = 0.024). TT grubu içindeki detorsiyon ve orşiektomi alt grupları arasındaki karşılaştırmada, ilki istatistiksel olarak daha düşük monosit sayısına (p = 0,005) ve MLR düzeyine (p = 0,038) sahipti.Sonuç: Hematolojik parametrelerin; yani, tam kan sayımı analizinden kolaylıkla belirlenebilen WBC, MPV ve NLR, TT’yi tahmin etmek için Doppler ultrasonografiye benzer şekilde yüksek duyarlılığa ve özgüllüğe sahipti. Ayrıca TT cerrahisinde orşiektomi veya detorsiyon kararında güçlük çekilen olgularda monosit ve MLR düzeylerinin faydalı olabileceğini düşünüyoruz.

Anahtar Kelimeler:

Akut skrotum, testis torsiyonu, epididimo-orşit, ortalama trombosit hacmi, nötrofil/lenfosit oranı

Comparison of hematological markers between testicular torsion and epididymo-orchitis in acute scrotum cases

Objective: In this study, we aimed to investigate the benefit of hematological results in determining the differential diagnosis between testicular torsion (TT) and epididymo-orchitis (EO) in patients presenting with acute scrotum, and to determine its predictive value for the diagnosis of TT.Material and Methods: We retrospectively analyzed 98 patients who applied to our institute’s urology clinics or emergency service with complaints of acute scrotum. Thirty-two patients who underwent orchiectomy or detorsion due to TT and 48 patients with EO were included in the study. The control group consisted of 80 healthy men. Groups were compared in terms of hematological parameters such as age, white blood cell (WBC), mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), and platelet/lymphocyte ratio (PLR).Results: WBC, MPV and NLR were found to be statistically significant in distinguishing TT group from other groups, respectively; (AUC = 0.732, 95% CI: 0.647-0.816 and p<0.001), (AUC = 0.720, 95% CI: 0.615-0.825 and p<0.001), (AUC = 0.629, 95% CI: 0.519-0.739 and p=0.024). In the comparison between the detorsion and orchiectomy subgroups within the TT group, the first had a statistically lower monocyte count (p=0.005) and MLR level (p=0.038).Conclusion: Hematological parameters; that is, WBC, MPV and NLR, which can be easily determined from complete blood count analysis, had high sensitivity and specificity similar to Doppler ultrasonography to predict TT. In addition, we think that monocyte and MLR levels may be beneficial in patients who have difficulty in the decision of orchiectomy or detorsion in TT surgery.

Keywords:

acute scrotum, testicular torsion, epididymo-orchitis, mean platelet volume, neutrophil/lymphocyte ratio,

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