Early diagnosis of testicular torsion in rats by measuring plasma d-dimer levels: comparative study with epididymitis

Purpose: To evaluate the differential diagnosis of testicular torsion and acute epididymo-orchitis by measuring the acute increase in plasma D-dimer levels in an experimental rat model. Methods: Thirty male Wistar rats were randomly divided into 5 groups, 1 - sham operated group (acute term; 4 hours), 2 - early torsion group (acute term; 4 hours), 3 - late torsion group (long-term; 72 hours), 4 - control of epididymitis group (vehicle injected; 0.1 ml physiologic saline injected into the left ductus deferens) (long term; 72 hours), 5 - epididymitis group (0.1 ml Escherichia coli injected into the left ductus deferens), (n = 6 for each group). Results: Serum D-dimer levels were significantly higher compared with the sham operated group with early torsion (p = 0.002). This elevation remained mildly in the late torsion group compared with the control group (p < 0.001), but there was no difference between 4 and 72 hours of the testis torsions (p = 0.794). On the other hand, D-dimer levels were significantly higher in the torsion groups compared to the epididymitis group (p = 0.042). Conclusions: The present study demonstrated that testicular damage that occurs following testicular torsion shows a higher increase in D-dimer levels than epididymitis, suggesting that D-dimer level can be used as a diagnostic marker of testicular torsion. (C) 2015 Elsevier Inc. All rights reserved.