Protective effects of Tadalafil and darbepoetin against ischemia - reperfusion injury in a rat testicular torsion model

ABSTRACT Objectives: To evaluate protective effects of darbepoetin and tadalafil against ischemia-reperfusion injury in ipsilateral and contralateral testicle. Materials and Methods: Thirty 3-month-old adult male Wistar-Albino rats were randomly divided into 5 groups (A-E). Sham operation was performed in the first group. In Group B, rats did not received any medication after creating 720 degrees torsion of the left testis. The rats in Group C, D and E received darbepoetin, tadalafil, and darbepoetin/tadalafil combination 30 minutes after creating 720 degrees torsion of the left testis, respectively. The testes of rats in these three groups were detorsioned at 90 minutes after drug administration. Both testes were removed at 30 minutes after detorsion. Results: There were significant differences between the groups in terms of the degree of histopathological damage, Johnsen score, fibrosis score and caspase-3 immunoreactivity in the torsioned testes (p: 0.000). The results for each parameter in the left testes were significantly better in the darbepoetin / tadalafil combination group. Similarly, there were also significant differences in the contralateral testes (p: 0.000). Conclusion: The active substances darbepoetin and tadalafil that were used as a combination had protective effects on both testes and produced out better results in preserving testicular histology. Especially in cases where it is not possible to rescue the torsioned testis, this result was more noticeable in the contralateral testis.

The protective effect of Papaverine and Alprostadil in rat testes after ischemia and reperfusion injury

ABSTRACT Objective: To investigate the effect of papaverine and alprostadil on testicular torsion-detorsion injury in rats. Materials and Methods: A total of 40 male Wistar-Albino rats were used in this study. Four hours of right testicular torsion was applied to each group, excluding sham oper- ated group. The torsion-detorsion (T/D), T/D + papaverine and T/D + alprostadil groups received saline, papaverine and alprostadil at the same time as surgical detorsion, respectively. At 14 days after the surgical detorsion, ischaemic changes and the degree of damage were evaluated with Cosentino scoring and the Johnson tubular biopsy score (JTBS). Results: JTBS was determined as 8.8±2.7 in the Sham group, 5.08±1.9 in the T/D+papaverine group, 5.29±2.3 in the T/D +alprostadil group and 2.86±1.9 in the TD group. The JTBS was determined to be statistically significantly high in both the T/D + papaverine group and the T/D + alprostadil group compared to the T/D group (p=0.01, p=0.009). In the T/D + papaverine group, 3 (43%) testes were classified as Cosentino 2, 3 (43%) as Cosentino 3 and 1 (14%) as Cosentino 4. In the T/D +alprostadil group, 5 (50 %) testes were classified as Cosentino 2, 3 (30 %) as Cosentino 3 and 2 (20%) as Cosentino 4. Conclusion: The present study indicated that spermatic cord administration of alprostadil and papaverine showed a protective effect against ischemia/reperfusion injury after right-side testes torsion and histological changes were decreased after testicular ischemia reperfusion injury.

Investigation of the antioxidant effects of pheniramine maleate and nebivolol on testicular damage in rats with experimentally induced testis torsion

Abstract Purpose: To investigate the biochemical, histopathologic, and spermatogenetic changes in the detorsionated testicle after experimental torsion and to study the antioxidant effects of pheniramine maleate and nebivolol. Methods: Twenty-four Sprague-Dawley male rats were divided into 4 groups: Group 1: Sham; Group 2: Torsion/Detorsion (T/D); Group 3: T/D + Pheniramine maleate (PM); Group 4: T/D + Nebivolol (NB) group. Paroxanase (PON), total antioxidant status (TAS), total oxidant status (TOS), and oxidative stres index (OSI) were measured, and spermatogenetic and histopathologic evaluation was performed in tissue and blood samples. Results: The evaluation of tissue TAS indicated no statistically significant difference in Group 3 compared to Group 2. A statistically significant increase was detected in Group 4 compared to Group 2. Serum PON levels revealed a statistically significant increase in Groups 3 and 4 compared to Groups 1 and 2. The Johnsen testicular biopsy score decreased in Groups 3 and 4, but the decrease was not statistically significant. Conclusions: Pheniramine maleate and nebivolol have antioxidant effects against ischemia-reperfusion damage. They also support tissue recovery, which is more significantly observed by nebivolol.

Cocaine abuse that presents with acute scrotal pain and mimics testicular torsion

ABSTRACT Report case (s) relevant aspects: Man, 27 years old, complaining of acute testicular pain by 2 hours in the remaining left testicle. Denies fever, lower urinary tract symptoms such as dysuria, urinary frequency, concommitant or prior urethral discharge to the painful condition. He underwent right orchiectomy 13 years ago by testicular torsion. He is a chronic user of cocaine for 15 years and during the last three days the drug use was continuous and intense. Proposed premise substantiating case (s) description: Initial diagnostic hypothesis: Syndromic: Acute Scrotum Syndrome (SEA) Main Etiologic (testicular torsion) Secondary Etiologic (acute orchiepididymitis) Briefly delineates what might it add? Lines of research That Could be Addressed: In this challenging clinical case we presented an alternative and new etiologic diangosis for the acute scrotum which the main etiologic factor remains testicular torsion. This new diangosis is acute testicular ischemia as a complication of cocaine abuse.

The antioxidant effect of dexmedetomidine on testicular ischemia-reperfusion injury

PURPOSE: To investigate the protective effect of dexmedetomidine (Dex) on testicular damage induced by ischemia-reperfusion injury in rats. METHODS: Sham group underwent left scrotal exploration only (group 1). The ischemia-reperfusion only group underwent left testicular torsion and detorsion (group 2). The ischemia-reperfusion plus Dex group underwent left testicular torsion, received 50 µg/kg Dex (group 3) and 100 µg/kg Dex (group 4) intraperitoneally at minute 180 of ischemia and then underwent detorsion. We determined histopathological findings and performed specific biochemical analyses. RESULTS: Increasing doses of Dex significantly increased TAS, and significantly decreased OSI. Analyzing the antioxidant effects of increasing doses of Dex in torsion and contrlateral testicles: Dex 100 µg/kg statistically significant increased the tissue total antioxidant status (TAS) and oxidative stress index (OSI) when compared with Dex 50 µg/kg but not found significantly change on the tissue total oxidant status (TOS). However, Dex did not significantly improve these histological alterations. CONCLUSION: The antioxidant effects of dexmedetomidine on testicular ischemia-reperfusion injury in ipsilateral and contrlateral testis, but in the histopathological level, there was no difference statistically according to Johnsen's scoring system between groups at both sides. .

Decompressive fasciotomy in testicular torsion of the spermatic cord in rats

PURPOSE: To evaluate the effect of decompression fasciotomy on testes undergoing torsion of the spermatic cord. METHODS: Spermatic cord torsion was induced in 40 Wistar testes for six and 12 hours. At the time of distortion, decompression fasciotomy was performed on half of the animals. After 42 days, the testicles were examined both macroscopically and microscopically. A non-parametric Mann- Whitney U- test was used for statistical analysis. The results were considered significant at p≤0.05. RESULTS: Testicular weight; volume and degree of histological alterations were evaluated. When the groups without and with fasciotomy were compared, a 12-hour torsion subgroup in the fasciotomy group was noted to present larger volume, heavier weight and superior histological classification when compared with the 12-hour subgroup in the without fasciotomy group. No differences between the two groups after six hours of torsion were found. No significant changes were noticed in the contralateral testis. CONCLUSIONS: Testicular fasciotomy (decompression) benefited the macroscopic and histological aspects of the testicles undergoing cord torsion for a 12-hour period. These results demonstrate the role played by compartment syndrome in the pathophysiology of spermatic cord torsion and the need for decompression.

Sertoli cell tumors associated with feminizing syndrome and spermatic cord torsion in two cryptorchid dogs

The association of cryptorchidism, functional Sertoli cell tumors, and spermatic cord torsion has been rarely reported in the literature. Two dogs were admitted for bilateral skin alopecia and weight loss. Both animals were cryptorchid and displayed a pendulous preputial sheath, prostate hypertrophy, and increased levels of circulating oestrogen. Transabdominal palpation and ultrasonography revealed the presence of neoplastic retained gonads. During surgery, spermatic cord torsion was also detected in the enlarged neoplastic testes of both dogs. Histologic examination confirmed the presence of Sertoli cell tumors that were primarily responsible for the feminizing syndrome. Complete remission of all symptoms occurred within 3 months after orchiectomy.

Palliative effect of Pausinystallia macroceras on testicular ischemic reperfusion injury in Wistar rats: a histological study / Efecto paliativo de Pausinystallia macroceras sobre la lesión testicular por isquemia-reperfusión en ratas Wistar: un estudio histológico

Testicular torsion is a disorder involving the scrotum that results in a compromise of its blood supply. The aim was to investigate the effect of Pausinystallia macroceras (PM) on testicular histology following torsion-detortion at different time intervals ranging from 1 to 4 hours 65 mature male Wister rats allotted randomly into seven groups (A to G; E& F further divided into 4-subgroups). Each group/subgroup comprised 5 rats. Testis maintained in the torted position (T) for 1, 2, 3 and 4 hours in Groups A (AT1+PM), B (BT2+PM), C (CT3+PM) and D (DT4+PM). Group E subgroups (E1+PM, E2+PM, E3+PM, E4+PM -) were sham operated, without torsion served as the sham control. Group F subgroups (F1T1, F2T2, F3T3 and F4T4) were torted as in A. All animals (except groups F & G) treated with PM extract (0.1 g/kg.b.w/day) for 56 days. Group G rats (normal control). Testes processed for histological studies. In AT1+PM showed preserved seminiferous tubules. BT2+PM, revealed varying number of necrosed and apoptotic seminiferous tubules. Group CT3+PM rats were similar to BT2+PM although with a slightly higher proportion of seminiferous tubules had undergone necrosis. In DT4+PM, sections showed few viable spermatozoa within the seminiferous tubules. When compared to the torted group F; showed extensive areas of seminiferous tubular necrosis (F3T3) as well as damage to the interstitium; while in F4T4 there were no viable testicular tissues seen. In conclusion, PM significantly prevented the cellular changes and cell death observed especially in group AT1+PM and BT2+PM.

La torsión testicular es un trastorno que involucra el escroto resultando en un compromiso del suministro sanguíneo. El objetivo fue investigar el efecto de Pausinystallia macroceras (PM) en la histología testicular tras torsión-detorsión a intervalos de tiempo diferentes que van desde 1 a 4 horas en 65 ratas macho Wistar maduras, asignando aleatoriamente en siete grupos (desde A a G, mientras que E y F se dividieron en 4 subgrupos). Cada grupo/subgrupo estuvo compuesto por 5 ratas. Los testículos se mantuvieron en posición torsionada (T) durante 1, 2, 3 y 4 horas en los grupos A (AT1 + PM), B (BT2 + PM), C (CT3 + PM) y D (DT4 + PM). El grupo E, subgrupos (E1 + PM, E2 + PM + PM E3, E4 + PM) fueron operados por modelo sham sin torsión, que sirvió de control. El grupo F, subgrupos (F1T1, F2T2, F3T3 y F4T4) fueron torsionados como en A. Todos los animales (excepto los grupos F y G) fueron tratados con extracto de AM (0,1 g/kg peso corporal/día) durante 56 días. El grupo G fueron ratas control (control normal). Los testículos fueron procesados para el estudio histológico. En AT1 + PM se observó preservación de los túbulos seminíferos. BT2 + PM, reveló un número variable de túbulos seminíferos con necrosis y apoptosis. El grupo de ratas CT3 + PM fue similar a BT2 + PM, aunque un porcentaje ligeramente superior de los túbulos seminíferos mostraron necrosis. En DT4 + PM, los cortes mostraron pocos espermatozoides viables dentro de los túbulos seminíferos. En comparación con el grupo F torsionado mostró extensas áreas de necrosis tubular (F3T3), así como daños en el intersticio; mientras que en F4T4 no hubo tejido testicular viable. En conclusión, PM previno significativamente cambios celulares y la muerte celular observada, especialmente en el grupo AT1 + PM y BT2 + PM.

Intrascrotal anomalies related to testicular torsion in nigerians: an anatomical study

Objective: The abnormalities that predispose to torsion are often bilateral. They include horizontally lying testis; bell-clapper deformity (BCD); long mesorchium; well-developed spiral cremasteric muscle and ectopic testis. The pattern and incidence of intrascrotal anomalies that predispose to testicular anomalies in Nigerians have not been studied. Our objective was to define and document this. Material and Methods: The scrotal sacs of fifty cadaver scrotums and inguinal canals from patients aged between 35 and 57 years (mean age: 42 years) were examined. The parameters studied were the location (scrotal or canalicular); alignment (horizontal; vertical); mesorchium (height and width); cremasteric muscle development (well or poorly developed) and parietal tunica vaginalis investment of the testis (normal; intermediate or BCD). Results: Forty-nine testes had descended to the scrotal position; all were anchored by the ligamentum testis. The canalicular position was noted to be present in one cadaver. Forty-eight testes lay vertically. 16of the testes had BCD; while intermediate tunica investment was noted in 12. The most common type of epididymal and testicular relationship was Type I (84). The mesorchium was normal in all specimens examined. Conclusion: The most common anomaly in our study was that of tunica investment; and this is usually bilateral. The need for bilateral orchiopexy in cases of testicular torsion is further strengthened since the anatomic anomalies are usually bilateral

Efeito do alopurinol sobre a morfologia do testículo do rato submetido a isquemia, pela torção do cordão espermático seguida de reperfusão / Effect of allopurinol on rat testicles morfology, submited to ischaemia for spermatic cord torsion followed by reperfusion

OBJETIVO: Estudar o efeito do alopurinol no fenômeno de isquemia-reperfusão em testículos de ratos. MÉTODOS: Foram utilizados 80 ratos Wistar, adultos, distribuídos em 4 grupos: controle sem alopurinol, controle com alopurinol, torção do cordão espermático sem alopurinol e torção do cordão espermático com alopurinol. Os testículos foram retirados após 60 dias do ato operatório e processados para exame histológico à microscopia óptica, onde os túbulos seminíferos e as células espermatogênicas foram objeto de estudo. RESULTADOS: A comparação entre os grupos demonstrou que houve atrofia dos testículos que foram submetidos à torção, inclusive o grupo que recebeu o alopurinol. CONCLUSÃO: O alopurinol não protegeu as gônadas dos efeitos da isquemia reperfusão.

Anatomic aspects of epididymis and tunica vaginalis in patients with testicular torsion

OBJECTIVE: To analyze the morphology of epididymis and tunica vaginalis as well as their anatomical anomalies in patients with testicular torsion. MATERIALS AND METHODS: We studied 25 patients (50 testes) aged between 12 and 23 years (mean 15.6). Torsion length ranged from 2 hours to 2 days (mean 8 hours). Epididymal anatomy was classified in 6 groups: Type I - epididymis united to the testis by its head and tail; Type II - epididymis totally united to the testis; Type III - disjunction of epididymal tail; Type IV - disjunction of epididymal head; Type V - total disjunction between testis and epididymis, and Type VI - epididymal atresia. The type of torsion was classified in 3 groups: Group A - intravaginal torsion; Group B - extravaginal torsion and Group C - torsion due to long mesorchium. RESULTS: Of the 50 analyzed testes, 40 (80 percent) presented bell clapper deformity (with 21 presenting intravaginal torsion); 8 testes (16 percent) had long mesorchium (4 with torsion), and only 2 (4 percent) presented normal anatomy in the tunica vaginalis. The most frequently found anatomical relationship between testis and epididymis was Type I - 38 cases (76 percent); Type II relationship was found in 6 cases (12 percent) and Type III relationship was found in 6 cases (12 percent). CONCLUSIONS: Intravaginal torsion is the most frequent type, and torsion due to long mesorchium is associated with cryptorchism. The most frequently found anatomical relation between testis and epididymis in the study group was Type I.

Protesis testicular de acrílico / Acrilic testicular prosthesis

Se presenta la experiencia del Servicio de Cirugía Pediátrica del Hospital Gustavo Fricke en el uso de Prótesis Testiculares de Acrílico (PTA), en los últimos 15 años. Se revisaron las historias clínicas de 45 pacientes a los que se les instaló un total de 55 prótesis. Se comparan los resultados obtenidos con los entregados por la literatura. Recomdamos el uso de las PTA durante la edad pediátrica, mientras el paciente tiene la edad suficiente para recibir una prótesis de adulto. Además, la aconsejamos por su fácil fabricación, buena tolerancia y bajísimo costo, lo que la hace accequible a los pacientes hospitalarios

The Effect of Testicular Torsion on the Contralateral Testis in Rats; Histologic Changes and its Reversibility

Unilateral torsion of the testis was experimentally induced in Sprague-Dowley rats by an incision in the scrotum and manual rotation of the testis. The testes remained torted for 3 or 24 hours and then were released by detorsion or orchiectomy. Histologic changes were evaluated 2 weeks and 4 weeks post torsion episode in order to answer the following questions:(1) Does the duration of testicular torsion affect the degree of histologic change in the contralateral testis? (2) Does the treatment of the torted testis influence the contralateral testis histologically? (3) Are there any histologic differences according to the duration of the follow-up in each group? The results indicate that when a torted testis was kept in place for at least 24 hrs, then was a marked decrease in spermatogenesis, but even this histologic change disappeared 4 weeks later. In conclusion a torted testis may present a liability to the patient's contralateral testis, but this phenomena is temporal.