Predictive Value of the Neutrophil/Lymphocyte Ratio in Testicular Torsion

Objective: The association between blood markers and testicular viability after testicular torsion (TT) is not well known. Here, the role of the neutrophil-tolymphocyte ratio (NLR) in predicting testicular viability in children with TT was evaluated.
Methods: Clinical data of eighty children younger than 18 years of age who underwent TT between 2018 and 2023 were analyzed. Age, symptom duration, degree of spermatic cord torsion, surgical approach adopted, and hematological parameters including neutrophil, lymphocyte, and C-reactive protein (CRP) levels were obtained. The NLR was calculated.
Results: The median age was 14 (1-17) and the median duration of symptoms was 24 h (1-168 h). Testicular blood flow in color Doppler ultrasonography was absent in 64 patients (81%). During scrotal exploration, 39 patients (49%) underwent orchiopexy and 41 (51%) underwent orchiectomy. Median NLR (2.8 vs 5 p<0.001), and CRP (2.6 vs 27 p<0.001) were higher among patients who underwent orchiectomy. Patients with higher than 3.5 NLR were significantly more likely to undergo orchiectomy (37% vs 63%).
Conclusion: NLR and CRP were significantly associated with testicular viability, and both parameters can be used to predict the outcome of testis in TT.