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

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Asian Journal of Andrology 2016年第3期18卷 462-466,I0010,I0011页

作者： tamas jozsat Zoltan Klarik Ferenc Kiss Eniko Toth Anita Mester Zoltan Hargitai Yi-Che Changchien Magdalena Fossum Norbert Nemeth Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden Department of Pediatric Surgery Division of Urology Astrid Lindgren Children's Hospital. Karolinska University Hospital Stockholm Sweden Department of Operative Techniques and Surgical Research Institute of Surgery Faculty ot MedicineUniversity of Debrecen Hungary Department of Pathology Kenezy Gyula Hospital Uebrecen Hungary

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.

关键词： ischemia rat model reperfusion spermatic cord torsion surgical flaps testicular compartment syndrome testis

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