Open AccessEstablishment and internal validation of preoperative nomograms for predicting the possibility of testicular salvage in patients with testicular torsion
Author(s) -
Wanxiang Zheng,
Guangdong Hou,
Wei Zhang,
Di Wei,
Xuelin Gao,
Meihong Chen,
Luguang Huang,
Fei Yan,
Geng Zhang,
Yu Lei,
Fei Liu,
Bo Zhang,
Jianlin Yuan
Publication year - 2021
Publication title -
asian journal of andrology/asian journal of andrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.701
H-Index - 74
eISSN - 1745-7262
pISSN - 1008-682X
DOI - 10.4103/aja.aja_31_20
Subject(s) - nomogram , testicular torsion , orchiopexy , medicine , receiver operating characteristic , logistic regression , univariate , multivariate analysis , univariate analysis , orchiectomy , multivariate statistics , homogeneous , surgery , urology , statistics , mathematics , combinatorics
This study aimed to establish nomograms to preoperatively predict the possibility of testicular salvage (TS) in patients with testicular torsion. The clinical data of 204 patients with testicular torsion diagnosed at Xijing Hospital and Tangdu Hospital (Xi'an, China) between August 2008 and November 2019 were retrospectively analyzed. Univariate and multivariate logistic regression analyses were used to determine the independent predictors of TS. Based on multivariate regression coefficients, nomograms to predict possibility of TS were established. The predictive ability of the nomograms was internally validated by receiver operating characteristic (ROC) curves and calibration plots. The duration of symptoms ranged from 2 h to 1 month, with a median of 3.5 days. Thirty (14.7%) patients underwent surgical reduction and contralateral orchiopexy, while the remaining 174 (85.3%) underwent orchiectomy and contralateral orchiopexy. Finally, long symptom duration was an independent risk predictor for TS, while visible intratesticular blood flow and homogeneous testicular echotexture under color Doppler ultrasound were independent protective predictors. Internal validation showed that the nomograms, which were established by integrating these three predictive factors, had good discrimination ability in predicting the possibility of TS (areas under the ROC curves were 0.851 and 0.828, respectively). The calibration plots showed good agreement between the nomogram-predicted possibility of TS and the actual situation. In conclusion, this brief preoperative prediction tool will help clinicians to quickly determine the urgency of surgical exploration.