Clinical and laboratory predictors of testicular loss in pediatric torsion patients

Objectives: Pediatric testicular torsion (TT) requires emergency surgical intervention to prevent testicular loss. This study aimed to examine clinical and laboratory parameters that predict intraoperative orchidectomy and testicular atrophy (TA) at one-year follow-up, with a focus on symptom duration and inflammatory biomarkers. Materials and methods: A retrospective cohort study included 90 pediatric patients ( < 18 years) who underwent surgical exploration for TT. Clinical predictors included age, symptom duration, scrotal findings (pain, swelling, redness, high-riding testis), and preoperative preparation time. Laboratory parameters included leukocyte count, platelet count, mean platelet volume (MPV), and C-reactive protein (CRP). Testicular vascularization (normal vs. pathologic) was assessed preoperatively at presentation using color Doppler ultrasound (CDUS). Outcomes were orchiectomy or orchiopexy, and testicular atrophy (≥80% volume loss) at one-year follow-up. Multivariate logistic regression was used to identify independent predictors of testicular loss. Results: = 0.002). Multiple logistic regression indicated considerably increased odds ratios of orchidectomy with symptom duration > 12 hours, younger age, longer preoperative preparation times, and elevated CRP. Conclusion: Delayed presentation ( > 12 hours), younger age, elevated CRP, and longer preoperative preparation time were identified as the strongest predictors of orchidectomy and subsequent testicular atrophy. Symptom duration remained the most critical determinant of failed testicular salvage. These findings highlight the importance of timely recognition and prompt surgical management to optimize outcomes in pediatric testicular torsion.