Abstract：
OBJECTIVE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
摘要：
目的：在睾丸扭转（TT）的情况下，及时的诊断和治疗与器官抢救高度相关，和手动扭曲（MD）是推荐的机动作为第一干预。在我们的研究中,我们旨在探讨TT的预测因素在预测MD成功中的作用。
方法：回顾性研究，对2015年1月至2024年之间诊断为TT的患者进行了2中心研究。人口统计,临床,超声，并分析了演示时的实验室特征。在所有患者中常规进行MD作为第一干预。在MD成功和失败组中比较了预测参数。采用单因素和多因素logistic回归分析确定MD衰竭的危险因素。
结果：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。经多普勒超声检查确诊的MD在52例（55.3％）患者中成功，在42例（44.7％）中失败。年龄,症状持续时间,睾丸缺血和疑似扭转(TWIST)评分,TWIST风险组,WBC,中性粒细胞,单核细胞计数,单核细胞/嗜酸性粒细胞比值(MER)在两组间有统计学差异。在多元逻辑回归分析中，发现MD失败的危险因素是18岁以上，症状持续时间超过9小时，MER>28
结论：目前的泌尿外科指南表明，年龄，症状持续时间,MER是MD成功的可靠预测因子，建议在所有TT病例中使用。
方法：回顾性研究，对2015年1月至2024年之间诊断为TT的患者进行了2中心研究。人口统计,临床,超声，并分析了演示时的实验室特征。在所有患者中常规进行MD作为第一干预。在MD成功和失败组中比较了预测参数。采用单因素和多因素logistic回归分析确定MD衰竭的危险因素。
结果：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。经多普勒超声检查确诊的MD在52例（55.3％）患者中成功，在42例（44.7％）中失败。年龄,症状持续时间,睾丸缺血和疑似扭转(TWIST)评分,TWIST风险组,WBC,中性粒细胞,单核细胞计数,单核细胞/嗜酸性粒细胞比值(MER)在两组间有统计学差异。在多元逻辑回归分析中，发现MD失败的危险因素是18岁以上，症状持续时间超过9小时，MER>28
结论：目前的泌尿外科指南表明，年龄，症状持续时间,MER是MD成功的可靠预测因子，建议在所有TT病例中使用。
