Predictive value of hematologic parameters and HALP score for testicular viability in adults with testicular torsion: A multicentric study

Objectives: To evaluate the predictivity of haematologic parameters and HALP score on testicular viability in adults with testicular torsion. Methods: We retrospectively analyzed the clinical data of 139 men >= 18 years of age who underwent testicular detorsion with fixation (n = 90) or orchiectomy (n = 49) due to testicular torsion in five different tertiary centers between May 2019 and August 2023. Demographic, pre-, peri- and postoperative data were analyzed. Results: The hemoglobin, albumin, lymphocyte, and platelet (HALP) score in the orchiectomy group was significantly lower compared to the detorsion group (adjusted p = 0.032). Platelet to lymphocyte ratio and duration of torsion were significantly higher in the orchiectomy group (adjusted p = 0.048, adjusted p = 0.000, respectively). Neutrophil-lymphocyte ratio did not reach statistical significance between the groups (adjusted p = 0.074) Furthermore, the orchiectomy group had statistically significantly more heterogeneous echotexture on scrotal ultrasonography (adjusted p = 0.000). On binary logistic regression analysis; platelet-lymphocyte ratio and HALP score were not found as significant predictors for surgical outcome (p = 0.296, p = 0.078, respectively). Multivariate logistic regression analysis revealed that only heterogeneous echotexture on scrotal Doppler ultrasonography and duration of torsion were independent risk factors for testicular necrosis development (p = 0.004, p < 0.001, respectively). Conclusions: This study demonstrates that heterogeneous echotexture on ultrasound and longer duration of torsion seem to be independent risk factors for testicular necrosis after testicular torsion in adults. However, neither haematologic parameters nor HALP score provided valuable information for testicular viability before scrotal exploration in our series.