Assessment of Near-Infrared Spectroscopy in the Diagnosis of Testicular Torsion in Children

No rapid test to diagnose testicular torsion (TT) exists. The usefulness of trans-scrotal near-infrared spectroscopy (NIRS) remains to be proven in children. Here, we measured testicular oxygenation (StO₂%) in children with unilateral TT and compared values to those measured in children with another cause of testicular pain and in control subjects.

StO₂% values were measured in 32 boys with unilateral testicular pain (group 1: 19 with TT, 7 without TT, 6 with torsion-detorsion) and in a control group (group 2: CG) of 35 healthy boys, aged 0-16 years. The difference in StO₂% between the two testicles for the groups was compared (paired or unpaired Student's tests, or Wilcoxon and Mann-Whitney tests; p < 0.05).

In the CG, the mean StO₂% was 74.2 % (SD:15.5) on the right and 73.4 % (SD:14.0) on the left. In group 1 TT, the mean StO₂% was 68.3 % (SD:15.3) on the TT side vs 69.8 % (SD:16.9) on the contralateral side. The difference between the two sides was not significant for either group (CG: 3.2 % [SD:16.8], p = 0.6; Group 1 TT: -2.8 % [SD:16.6], p = 0.4). For patients with severe testicular inflammation without TT, a non-significant trend for greater differences between sides was observed (71.8 % [SD:12.6] vs 82.8 % [SD:14.6]; Delta -14.8 % [SD:18.5], p = 0.2).

NIRS is not suitable to diagnose TT in children in clinical practice. StO₂% values showed extensive intra- and inter-individual variability in both control and TT subjects, with or without necrosis. Inflammatory pathologies appear to have a greater impact on StO₂%.

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