Diagnostic value of immature granulocytes in the differential diagnosis of testicular torsion and epididymo-orchitis in acute scrotum
Abstract
Aims: This study aimed to evaluate the discriminatory performance of immature granulocyte (IG) count in differentiating testicular torsion from epididymo-orchitis.
Methods: In this retrospective observational study, 27 patients with testicular torsion, 65 patients with epididymo-orchitis and 90 control group who presented with acute scrotal pain between May 2023 and December 2025 were included. White blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), immature granulocyte count (IG) and IG percentage (IG%) were evaluated in all participants. The diagnostic performance of these parameters was assessed using receiver operating characteristic (ROC) curve analysis and independent predictors were determined by multivariable logistic regression analysis.
Results: WBC, NLR, CRP, IG and IG% levels were significantly higher in the epididymo-orchitis group compared to both the testicular torsion and control groups (all p<0.001). In differentiating epididymo orchitis from testicular torsion, CRP demonstrated the highest diagnostic performance (AUC=0.86, 95% CI: 0.79-0.92), followed by NLR (AUC=0.83), IG (AUC=0.82), WBC (AUC=0.80) and IG% (AUC=0.79) (all p<0.001). In multivariable logistic regression analysis; IG (OR=2.85, 95% CI: 1.46-4.25, p<0.05), NLR (OR=1.75, 95% CI: 1.20-2.55, p<0.05) and CRP (OR=1.08, 95% CI: 1.02-1.15, p<0.05) were identified as independently associated with epididymo-orchitis. In a secondary model additionally adjusted for symptom duration, IG remained independently associated with epididymo-orchitis (OR=2.40, 95% CI: 1.20-5.10, p<0.05).
Conclusion: IG count may provide complementary information in the differential assessment of testicular torsion and epididymo-orchitis. These findings should be interpreted as supplementary to clinical assessment and imaging and should not be used to exclude testicular torsion or delay definitive management.
Keywords
Supporting Institution
No supporting institution
Ethical Statement
The study protocol was approved by the Ethics Committee of the Faculty of Health Sciences, Osmaniye Korku Ata University (Decision No: 3, Document No: OKU.KKO.FR.0024, Date: 02/03/2026). The study was conducted in accordance with the principles of the Helsinki Declaration and its subsequent amendments.
Thanks
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References
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Details
Primary Language
English
Subjects
Urology
Journal Section
Research Article
Publication Date
October 25, 2026
Submission Date
May 11, 2026
Acceptance Date
October 21, 2026
Published in Issue
Year 2026 Volume: 8 Number: 6
APA
Yılmaz, B., & Yuvanç, E. (2026). Diagnostic value of immature granulocytes in the differential diagnosis of testicular torsion and epididymo-orchitis in acute scrotum. Anatolian Current Medical Journal, 8(6), 1373-1379. https://izlik.org/JA94ZZ34PJ
AMA
1.Yılmaz B, Yuvanç E. Diagnostic value of immature granulocytes in the differential diagnosis of testicular torsion and epididymo-orchitis in acute scrotum. Anatolian Curr Med J / ACMJ / acmj. 2026;8(6):1373-1379. https://izlik.org/JA94ZZ34PJ
Chicago
Yılmaz, Burak, and Ercan Yuvanç. 2026. “Diagnostic Value of Immature Granulocytes in the Differential Diagnosis of Testicular Torsion and Epididymo-Orchitis in Acute Scrotum”. Anatolian Current Medical Journal 8 (6): 1373-79. https://izlik.org/JA94ZZ34PJ.
EndNote
Yılmaz B, Yuvanç E (October 1, 2026) Diagnostic value of immature granulocytes in the differential diagnosis of testicular torsion and epididymo-orchitis in acute scrotum. Anatolian Current Medical Journal 8 6 1373–1379.
IEEE
[1]B. Yılmaz and E. Yuvanç, “Diagnostic value of immature granulocytes in the differential diagnosis of testicular torsion and epididymo-orchitis in acute scrotum”, Anatolian Curr Med J / ACMJ / acmj, vol. 8, no. 6, pp. 1373–1379, Oct. 2026, [Online]. Available: https://izlik.org/JA94ZZ34PJ
ISNAD
Yılmaz, Burak - Yuvanç, Ercan. “Diagnostic Value of Immature Granulocytes in the Differential Diagnosis of Testicular Torsion and Epididymo-Orchitis in Acute Scrotum”. Anatolian Current Medical Journal 8/6 (October 1, 2026): 1373-1379. https://izlik.org/JA94ZZ34PJ.
JAMA
1.Yılmaz B, Yuvanç E. Diagnostic value of immature granulocytes in the differential diagnosis of testicular torsion and epididymo-orchitis in acute scrotum. Anatolian Curr Med J / ACMJ / acmj. 2026;8:1373–1379.
MLA
Yılmaz, Burak, and Ercan Yuvanç. “Diagnostic Value of Immature Granulocytes in the Differential Diagnosis of Testicular Torsion and Epididymo-Orchitis in Acute Scrotum”. Anatolian Current Medical Journal, vol. 8, no. 6, Oct. 2026, pp. 1373-9, https://izlik.org/JA94ZZ34PJ.
Vancouver
1.Burak Yılmaz, Ercan Yuvanç. Diagnostic value of immature granulocytes in the differential diagnosis of testicular torsion and epididymo-orchitis in acute scrotum. Anatolian Curr Med J / ACMJ / acmj [Internet]. 2026 Oct. 1;8(6):1373-9. Available from: https://izlik.org/JA94ZZ34PJ
