ArticleArab journal of urology2026
Clinical and laboratory predictors of testicular loss in pediatric torsion patients.
Article in Arab journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: Pediatric testicular torsion (TT) requires emergency surgical intervention to prevent testicular loss. This study aimed to examine clinical and laboratory parameters that predict intraoperative orchidectomy and testicular atrophy (TA) at one-year follow-up, with a focus on symptom duration and inflammatory biomarkers. Materials and methods: A retrospective cohort study included 90 pediatric patients ( < 18 years) who underwent surgical exploration for TT. Clinical predictors included age, symptom duration, scrotal findings (pain, swelling, redness, high-riding testis), and preoperative preparation time. Laboratory parameters included leukocyte count, platelet count, mean platelet volume (MPV), and C-reactive protein (CRP). Testicular vascularization (normal vs. pathologic) was assessed preoperatively at presentation using color Doppler ultrasound (CDUS). Outcomes were orchiectomy or orchiopexy, and testicular atrophy (≥80% volume loss) at one-year follow-up. Multivariate logistic regression was used to identify independent predictors of testicular loss. Results: Forty patients underwent orchidectomy, and 50 underwent orchidopexy. Among those treated with orchidopexy, TS at one-year follow-up was achieved in 36 patients (72%). Age and type of vascularization were significantly different between patients from the orchidectomy and orchidopexy groups. There was a notably larger number of patients experiencing scrotal redness, swelling, or hardness in the orchidectomy group in comparison to the orchidopexy group. CRP was significantly higher in the orchidectomy group ( Conclusion: Delayed presentation ( > 12 hours), younger age, elevated CRP, and longer preoperative preparation time were identified as the strongest predictors of orchidectomy and subsequent testicular atrophy. Symptom duration remained the most critical determinant of failed testicular salvage. These findings highlight the importance of timely recognition and prompt surgical management to optimize outcomes in pediatric testicular torsion.
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