Department of Urology, Ankara Etlik Integrated Health Campus, Halil Sezai Erkut Street, Varlik, Etlik, Kecioren, 06170, Ankara, Turkey.
Int Urol Nephrol. 2024 Dec;56(12):3797-3804. doi: 10.1007/s11255-024-04151-0. Epub 2024 Jul 10.
In cases of testicular torsion (TT), prompt diagnosis and treatment are highly associated with organ salvage, and manual detorsion (MD) is a recommended maneuver as a first intervention. In our study, we aimed to investigate the effect of predictive factors of TT in predicting the success of MD.
A retrospective, 2-center study was conducted on patients diagnosed with TT between January 2015 and 2024. Demographic, clinical, ultrasound, and laboratory characteristics at presentation were analyzed. MD was routinely performed as the first intervention in all patients. Predictive parameters were compared in the MD success and failure groups. Univariate and multiple logistic regression analysis was used to identify risk factors for MD failure.
A total of 94 patients were included in the study. The median age of the patients was 20 (IQR: 12-69) years, and the median symptom duration was 6 (IQR: 4-12) hours. MD confirmed by Doppler ultrasonography was successful in 52 (55.3%) patients and unsuccessful in 42 (44.7%). Age, symptom duration, Testicular Workup for Ischemia and Suspected Torsion (TWIST) score, TWIST risk groups, WBC, neutrophil, monocyte counts, and Monocyte/Eosinophil ratio (MER) were statistically different between the two groups. In multiple logistic regression analysis, the risk factors for failure of MD were found to be being over 18 years of age, the duration of symptoms being longer than 9 h, and MER > 28.
Current urology guidelines suggest that age, symptom duration, and MER are reliable predictors of the success of MD, which is recommended in all cases of TT.
在睾丸扭转（TT）的情况下，及时诊断和治疗与保留器官高度相关，手动复位（MD）是推荐的一线干预措施。在本研究中，我们旨在探讨 TT 的预测因素对 MD 成功的影响。
对 2015 年 1 月至 2024 年间诊断为 TT 的患者进行回顾性、2 中心研究。分析就诊时的人口统计学、临床、超声和实验室特征。所有患者均常规行 MD 作为一线干预。比较 MD 成功和失败组的预测参数。采用单变量和多变量逻辑回归分析确定 MD 失败的危险因素。
本研究共纳入 94 例患者。患者的中位年龄为 20（IQR：12-69）岁，中位症状持续时间为 6（IQR：4-12）小时。多普勒超声检查证实 MD 成功 52 例（55.3%），失败 42 例（44.7%）。两组之间年龄、症状持续时间、睾丸缺血和疑似扭转检查（TWIST）评分、TWIST 风险组、白细胞、中性粒细胞、单核细胞计数以及单核细胞/嗜酸性粒细胞比值（MER）存在统计学差异。多变量逻辑回归分析发现，MD 失败的危险因素是年龄大于 18 岁、症状持续时间超过 9 小时以及 MER＞28。
目前的泌尿科指南建议年龄、症状持续时间和 MER 是 MD 成功的可靠预测因素，建议在所有 TT 病例中推荐 MD。
