Intraoperative indocyanine green near-infrared fluorescence imaging for assessing testicular viability in pediatric testicular torsion: A retrospective study.

Mingliu Huang; Xu Cao; Xiangming Yan; Lei Zhang; Zheng Fang; Ting Zhang; Mingcui Fu; Guochong Chen; Ting Feng; Hongliang Xia; Enfu Huang; Tianyi Wang; Shu Dai

doi:10.1016/j.jpurol.2026.106025

PubMed · 42208402

Intraoperative indocyanine green near-infrared fluorescence imaging for assessing testicular viability in pediatric testicular torsion: A retrospective study.

Mingliu Huang·Xu Cao·Xiangming Yan·Lei Zhang·Zheng Fang·Ting Zhang·Mingcui Fu·Guochong Chen·Ting Feng·Hongliang Xia·Enfu Huang·Tianyi Wang·Shu Dai

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Abstract

OBJECTIVE: To evaluate the clinical efficacy of indocyanine green near-infrared fluorescence (ICG-NIRF) imaging versus conventional surgery for assessing testicular viability and guiding decision-making in pediatric testicular torsion (TT). METHODS: A retrospective analysis was performed on 225 pediatric patients undergoing emergency scrotal exploration for TT between January 2019 and January 2025. Patients were categorized into a conventional surgery group (n = 118) relying on visual grading and an ICG-NIRF imaging group (n = 107). Primary outcomes included intraoperative testicular preservation rates and postoperative success rates. Multivariate Cox regression was utilized to identify factors influencing testicular preservation. RESULTS: Baseline characteristics were comparable between groups. The ICG-NIRF group demonstrated a significantly higher intraoperative preservation rate (74.77% vs. 61.02%, p = 0.028) and postoperative success rate (88.75% vs. 69.44%, p = 0.003) compared to the conventional group. Additionally, the ICG-NIRF group exhibited significantly lower rates of secondary orchiectomy (1.25% vs. 9.72%, p = 0.027) and 6-month testicular atrophy (7.59% vs. 23.08%, p = 0.02). Multivariate analysis confirmed ICG-NIRF application as an independent protective factor for testicular preservation (HR = 0.556, p < 0.001). CONCLUSION: ICG-NIRF imaging provides an objective, real-time assessment of testicular perfusion, significantly improving testicular preservation rates and postoperative outcomes. This technique overcomes the subjectivity of conventional visual methods, offering substantial clinical value for fertility preservation in pediatric TT.

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Humans Male Retrospective Studies Indocyanine Green Spermatic Cord Torsion Child Optical Imaging Testis Child, Preschool Adolescent Indocyanine green near-infrared fluorescence (ICG-NIRF)Surgical decision-making Testicular torsion Testicular viability assessment Journal Article

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Mingliu Huang, Xu Cao, Xiangming Yan, Lei Zhang, Zheng Fang, Ting Zhang, Mingcui Fu, Guochong Chen, Ting Feng, Hongliang Xia, Enfu Huang, Tianyi Wang, Shu Dai. 2026-05-15. Intraoperative indocyanine green near-infrared fluorescence imaging for assessing testicular viability in pediatric testicular torsion: A retrospective study.. https://doi.org/10.1016/j.jpurol.2026.106025

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