The authors reply: Predictive role of hematologic parameters in testicular torsion.

To the Editor:

Some hematologic markers, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and mean platelet volume (MPV), have gained popularity as possible predictive factors in oncologic and nononcologic inflammatory processes [123]. We have read the letter about our recently published report, "Predictive Role of Hematologic Parameters in Testicular Torsion" [4]. We thank the authors for their contribution about our article. We agree that hematologic parameters including the NLR and MPV may be affected by malignant or nonmalignant systemic diseases such as diabetes mellitus, hypertension, and thyroid disorders. However, our study population consisted of testicular torsion (TT) patients who had undergone scrotal exploration in emergency conditions. Therefore, routine evaluation of thyroid function tests had not been performed. Moreover, as we mentioned in our article, the mean age in our TT and control groups was 14 and 15 years, respectively. It can be appreciated that systemic inflammatory disorders do not usually occur in the early part of life. Besides, our control group comprised age-matched healthy subjects. We did not detect a significant difference between the groups in terms of malignant and nonmalignant inflammatory disorders [4].

Finally, in agreement with the authors, all systemic 2015inflammatory diseases may affect the level of hematologic markers. Further studies investigating the possible predictive role of these markers on various processes should consider the accompanying conditions that may influence the results.