Yilmaz Ahmet Burak, Ozercan Ali Yasin, Erkan Anil, Elmaagac Burak, Senel Cagdas, Keten Tanju, Kutluhan Musab Ali, Kizilkan Yalcin, Yildizhan Mehmet, Oner Suleyman, Demirbas Murat, Guzel Ozer, Ozdal Ozdem Levent, Karabulut Erdem, Tuncel Altug
Department of Urology, University of Health Sciences School of Medicine, Ankara City Hospital, Ankara, Turkey.
Department of Urology, Ministry of Health Sirnak State Hospital, Sirnak, Turkey.
Int J Urol. 2025 Mar;32(3):300-306. doi: 10.1111/iju.15650. Epub 2024 Dec 10.
To evaluate the predictivity of haematologic parameters and HALP score on testicular viability in adults with testicular torsion.
We retrospectively analyzed the clinical data of 139 men ≥18 years of age who underwent testicular detorsion with fixation (n = 90) or orchiectomy (n = 49) due to testicular torsion in five different tertiary centers between May 2019 and August 2023. Demographic, pre-, peri- and postoperative data were analyzed.
The hemoglobin, albumin, lymphocyte, and platelet (HALP) score in the orchiectomy group was significantly lower compared to the detorsion group (adjusted p = 0.032). Platelet to lymphocyte ratio and duration of torsion were significantly higher in the orchiectomy group (adjusted p = 0.048, adjusted p = 0.000, respectively). Neutrophil-lymphocyte ratio did not reach statistical significance between the groups (adjusted p = 0.074) Furthermore, the orchiectomy group had statistically significantly more heterogeneous echotexture on scrotal ultrasonography (adjusted p = 0.000). On binary logistic regression analysis; platelet-lymphocyte ratio and HALP score were not found as significant predictors for surgical outcome (p = 0.296, p = 0.078, respectively). Multivariate logistic regression analysis revealed that only heterogeneous echotexture on scrotal Doppler ultrasonography and duration of torsion were independent risk factors for testicular necrosis development (p = 0.004, p < 0.001, respectively).
This study demonstrates that heterogeneous echotexture on ultrasound and longer duration of torsion seem to be independent risk factors for testicular necrosis after testicular torsion in adults. However, neither haematologic parameters nor HALP score provided valuable information for testicular viability before scrotal exploration in our series.
评估血液学参数和HALP评分对成人睾丸扭转患者睾丸存活能力的预测性。
我们回顾性分析了2019年5月至2023年8月期间在五个不同的三级中心因睾丸扭转接受睾丸扭转复位固定术（n = 90）或睾丸切除术（n = 49）的139名年龄≥18岁男性的临床资料。分析了人口统计学、术前、术中及术后的数据。
睾丸切除组的血红蛋白、白蛋白、淋巴细胞和血小板（HALP）评分显著低于扭转复位组（校正p = 0.032）。睾丸切除组的血小板与淋巴细胞比值和扭转持续时间显著更高（校正p分别为0.048和0.000）。两组间中性粒细胞与淋巴细胞比值未达到统计学显著性（校正p = 0.074）。此外，睾丸切除组在阴囊超声检查中具有统计学显著更多的不均匀回声纹理（校正p = 0.000）。在二元逻辑回归分析中，未发现血小板与淋巴细胞比值和HALP评分是手术结果的显著预测因素（p分别为0.296和0.078）。多变量逻辑回归分析显示，只有阴囊多普勒超声检查中的不均匀回声纹理和扭转持续时间是睾丸坏死发生的独立危险因素（p分别为0.004和p < 0.001）。
本研究表明，超声检查中的不均匀回声纹理和较长的扭转持续时间似乎是成人睾丸扭转后睾丸坏死的独立危险因素。然而，在我们的系列研究中，血液学参数和HALP评分在阴囊探查前均未为睾丸存活能力提供有价值的信息。
