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Abstract

Volume 18, Issue 3 (May 2016) 18, 462–466; 10.4103/1008-682X.157546

Morphological and microcirculatory evaluation of the rat testis after detorsion with or without a capsular release with a tunica vaginalis flap

Tamás Józsa1, Zoltán Klárik2, Ferenc Kiss2, Eniko Tóth2, Anita Mester2, Zoltán Hargitai3, Yi-Che Changchien3, Magdalena Fossum1, Norbert Németh2

1 Department of Women's and Children's Health, Karolinska Institutet; Department of Pediatric Surgery, Division of Urology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden,
2 Department of Operative Techniques and Surgical Research, Institute of Surgery, Faculty of Medicine, University of Debrecen, Hungary,
3 Department of Pathology, Kenézy Gyula Hospital, Debrecen, Hungary,

Correspondence: Dr. T Józsa (tamas.jozsa@karolinska.se)

Abstract

Testicular torsion may lead to serious ischemia, and the viability depends on the duration of torsion and the effect of ischemia-reperfusion. Testicular decompression and tunica vaginalis flap application technique were introduced in 2008 by Kutikov et al. We aimed to examine the impact of this method on the testicular microcirculation and hemorheological parameters in a rat model. Six adult rats underwent bilateral scrotal exploration. Intravaginal torsion of the testis was created by 720° rotation on both sides for 2 h. After detorsion, the right testes underwent tunica albuginea incision and tunica vaginalis flap application. Testicular microcirculation was monitored and hematological parameters, erythrocyte deformability, and aggregation were determined. Measurements were performed before and after torsion, directly after detorsion, on the 1 st -2 nd and 8 th postoperative day. After the last sampling, testicles were removed to determine their volume for histological examinations. The microcirculatory parameters demonstrated slight differences between testicles. Apical zone of the left (nondecompressed) testicles had elevated compared to the middle zone (P < 0.05). On the 2 nd and 8 th day, the microcirculation of the testes normalized but not equally. The erythrocyte aggregation and deformability decreased by the 8 th day. Both testicles underwent atrophy and epithelial necrosis, but the volume of the decompressed ones was lower (1.07 ± 0.08 vs 1.25 ± 0.31). Histologically, there was no significant difference in epithelial damage score between decompressed and nondecompressed testes. In conclusion, 2-h ischemia led to alteration in testicular microcirculation, reduction in volume, changes in hemorheological parameters and serious epithelial necrosis both in decompressed and nondecompressed testicles without remarkable differences.

Keywords: ischemia; rat model; reperfusion; spermatic cord torsion; surgical flaps; testicular compartment syndrome; testis

Keywords: 14 July 2015

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