Pathological re-evaluation of testicular torsion specimens: Implications for surgical intervention strategies

This study aims to conduct a retrospective pathological analysis of testicular tissue specimens excised due to testicular torsion, to reassess the validity of previous surgical decisions and provide a comprehensive summary of the appropriate surgical indications for orchiectomy.

Medical records of patients who underwent orchiectomy due to testicular torsion at XXX Hospital between 2015 and 2023 were reviewed, and the excised testicular specimens were re-evaluated using the Mikuz grading system.

113 patients who underwent orchiectomy were included in this study. Following the Mikuz classification, 14 patients were classified as Grade 1, 31 as Grade 2, and 68 as Grade 3. A longer duration of symptoms was associated with a lower proportion of patients with Grade 1 testicular injury while increasing age was correlated with a higher likelihood of developing Grade 1. In the Grade 1 group, 78.6 % of patients had a monocyte count of less than 0.5 × 10⁹/L, whereas the monocyte counts in the Grade 2 and Grade 3 groups were significantly higher than those in the Grade 1 group.

The findings of this study indicate that 12.4 % (14/113) of patients who underwent orchiectomy had low-grade testicular injury. Currently, objective measures are deficient for assessing the extent of testicular injury post-torsion, necessitating cautious decision-making regarding orchiectomy during surgical intervention. Patients presenting with brief symptom duration and low monocyte count may be more suitable candidates for orchiopexy as opposed to orchiectomy.