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Diagnosis of Testicular Torsion and Differentiation From Other Pathologies Using Near-Infrared Spectroscopy

  • Yiğit Ali Üncü
    Affiliations
    Biomedical Optics Research Unit, Department of Biophysics, School of Medicine, Akdeniz University, Antalya, Turkey

    Akdeniz University, Vocational School of Technical Sciences, Department of Biomedical Equipment Technology, Antalya, Turkey
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  • Çağrı Akın Şekerci
    Affiliations
    Department of Urology, Faculty of Medicine, Marmara University, Istanbul, Turkey
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  • Selçuk Yücel
    Affiliations
    Department of Urology, Acibadem Mehmet Ali Aydinlar University Atakent Hospital, Istanbul, Turkey

    Department of Urology, Marmara University School of Medicine, Istanbul, Turkey
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  • Aslınur Sircan-Kucuksayan
    Affiliations
    Biomedical Optics Research Unit, Department of Biophysics, School of Medicine, Akdeniz University, Antalya, Turkey

    Department of Biophysics, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya, Turkey
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  • Haydar Kamil Çam
    Affiliations
    Department of Urology, Faculty of Medicine, Marmara University, Istanbul, Turkey
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  • Murat Savaş
    Affiliations
    Department of Urology, Antalya Training and Research Hospital, Antalya, Turkey
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  • Asıf Yıldırım
    Affiliations
    Department of Urology, İstanbul Medeniyet University School of Medicine, Ministry of Health İstanbul Göztepe Training and Research Hospital, Istanbul, Turkey

    Department of Urology, İstanbul Medeniyet University School of Medicine, Ministry of Health İstanbul Göztepe Dr. Süleyman Yalçın City Hospital, Istanbul, Turkey
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  • Koray Ağras
    Affiliations
    Urology Clinic, Ministry of Health Ankara Atatürk Training and Research Hospital, Ankara, Turkey

    Private Medical Office, Ankara, Turkey
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  • Mehmet Baykara
    Affiliations
    Department of Urology, Faculty of Medicine, Akdeniz University, Antalya, Turkey

    Department of Urology, Lara Anadolu Hospital, Antalya Turkey
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  • Murat Canpolat
    Correspondence
    Address correspondence to: Murat Canpolat, PhD., Biomedical Optics Research Laboratory, School of Medicine, Department of Biophysics, Akdeniz University, Room F1-18, Konyaaltı, Antalya 07070, Turkey.
    Affiliations
    Biomedical Optics Research Unit, Department of Biophysics, School of Medicine, Akdeniz University, Antalya, Turkey
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Published:January 12, 2023DOI:https://doi.org/10.1016/j.urology.2023.01.004

      Abstract

      Objective

      To develop a near-infrared (NIR) spectroscopy device to diagnose testicular torsion with high sensitivity and specificity. Specifically, we aim to investigate the differentiation between testicular torsion from other pathologies such as orchidoepididymitis, varicocele, and hydrocele.

      Methods

      Two LEDs with wavelengths of 660 nm and 940 nm were used as light sources in the device. Each wavelength was sent to the testicle successively, and a photodiode detected back-reflected diffuse light. The ratio of the light intensities of 660 nm and 940 nm was used as a diagnostic parameter. A multi-center clinical trial was performed in 5 different hospitals.

      Results

      In total, 62 patients in urology clinics with acute testicular pain have been recruited for the study. The developed NIR spectroscopy correctly defined all 8 testicular torsion cases. Besides, 3 orchidoepididymitis, 1 varicocele, and 3 hydrocele cases were correctly distinguished from testicular torsion. Only 1 hydrocele case was misdiagnosed as torsion. The range of the ratio was between 0.14 and 1.16 overall measurements. The ratio varied between 0.14 and 0.3 for the testicle with torsion. The ratio was between 0.49 and 1.16 for the normal testicle and testicle with other pathologies mentioned above.

      Conclusion

      We have chosen the threshold ratio of 0.4 to differentiate between the normal and torsion testis and diagnosed all the torsion cases among all normal and other pathologies. The developed optical device to diagnose testicular torsion is inexpensive, user-friendly, and works based on objective criteria with high sensitivity and specificity in real time.
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