Parameters Predicting Orchiectomy Risk in Acute Testicular Torsion: TMPEV Score

Area of Science:

• Urology
• Pediatric Surgery
• Emergency Medicine

Background:

• Acute testicular torsion (TT) poses a significant risk of orchiectomy.
• Identifying predictors of orchiectomy beyond surgical delay is crucial for testicular salvage.

Purpose of the Study:

• To identify parameters, in addition to time to surgery, that predict orchiectomy risk in acute testicular torsion (TT).

Main Methods:

• Retrospective analysis of 83 patients with acute TT across five Turkish health centers (2016-2023).
• Patients were categorized into Group I (orchiectomy) and Group II (testicular preservation).
• Statistical analysis to compare groups and identify predictors of testicular salvage.

Main Results:

• Time to surgery and mean platelet volume (MPV) were higher in the orchiectomy group (Group I).
• Prehn's sign negativity, normal testicular echogenicity, and normal testicular volume on ultrasound were more frequent in the testicular preservation group (Group II).
• A novel scoring system, Time, MPV, Prehn's sign, Echogenicity, and Volume (TMPEV), was developed to predict orchiectomy risk.

Conclusions:

• Factors beyond surgical delay, including MPV, Prehn's sign, and ultrasound characteristics, significantly influence testicular salvage outcomes in TT.
• The developed TMPEV scoring system shows promise for predicting orchiectomy risk.
• Further development of nomograms like TMPEV could lead to proactive management algorithms for TT.