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

Abstract

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.

Keywords

• testicular torsion
• inflammation
• differential diagnosis