Mononuclear cell count and testicular color predicting post-orchiopexy atrophy in children: A retrospective study

Testicular torsion is an emergency that requires rapid intervention to preserve testicular viability. However, even when the testis is salvaged, the risk of subsequent atrophy remains high, potentially impacting the patient's future reproductive function. This study aims to identify the risk factors associated with testicular atrophy following orchiopexy and to pinpoint critical time points for postoperative monitoring.

This retrospective study reviewed the clinical records of patients with testicular torsion who underwent orchiopexy at the Children's Hospital, Capital Institute of Pediatrics, Beijing, China, from January 2020 to June 2024, comparing baseline characteristics and postoperative Doppler ultrasound results between patients with and without testicular atrophy.

32 patients who underwent orchiopexy were followed up with ultrasound for more than 3 months, and 19 of them, or 59.4%, had atrophy in the affected testis. Compared to the atrophy-free group, the atrophy group exhibited significantly higher preoperative mononuclear cell counts, more pronounced purple color of the testis during surgery and less restoration of blood flow. By 3 months postoperatively, 78.9% of the testes in the atrophy group had developed atrophy, with the rate of atrophy slowing thereafter. In the atrophy-free group, testicular size continued to increase, indicating ongoing growth and development.

Mononuclear cell count and intraoperative testicular color are key predictive risk factors for testicular atrophy. Additionally, it is recommended that all patients undergo ultrasound follow-up at 3 months postoperatively.