Effect of sildenafil adminstration on ischemia/ reperfusion of the testis in adult albino rat light and electron microscopic study

ABSTRACT

Testicular torsion is a pathologic condition that renders the testis ischemic and surgical intervention is usually required to reestablish blood flow. To evaluate the role of sildenafil administered half an hour before reperfusion [detorsion] in preserving spermatogenesis and minimizing germ cell apoptosis. Thirty adult male albino rats were divided equally into three main groups. Group I as a control, group II subjected to left testicular torsion for 1 hour followed by detorsion and group III was injected intraperitoneally [I/P] with a single dose of 0.14mg/1ml of sildenafil solution 30 min before detorsion. All animals were sacrificed after 24 hours. Both testes of each group were extracted and processed for light and transmission electron microscopic study. Immuno-histochemical study using Fas-Ligand stain was done for detection of apoptotic cells. Morphometric measurements of the diameters of seminiferous tubules, number of germ cells and apoptotic cells as well as Leydig cells were performed and subjected to statistical analysis. Revealed that unilateral testicular Torsion/Detorsion [T/D] induced marked damage of both testes with more affection of the ipsilateral side. Both testes revealed defective spermatogenesis with wide areas of cell loss and absence of early spermatids. Morphometric results of both testes revealed significant increase of number of apoptotic germ cells together with a significant decrease of the number of both germ cells and Leydig cells as compared to control. Ultrastructurally, Sertoli cells of both sides revealed large cytoplasmic vacuoles with interrupted inter-sertoli junctional specialization. Primary spermatocytes of both sides exhibited shrunken nuclei with dense clumped chromatin and damaged cytoplasmic organelles. The early and late spermatids showed abnormal appearance. On the contrary, sildenafil-treated group revealed a protective effect of sildenafil on both sides. This was proved ultrastructurally and by the morphometric results, which showed significant increase of the number of both germ and Leydig cells with significant decrease of apoptotic germ cell number as compared with T/D group. Sildenafil pretreatment could be promising as an adjuvant therapy to surgical repair for rescuing the testis from ischemia/reperfusion. Hence, orchidectomy could be avoided