Long-term effects of orchiopexy and orchiectomy on the testes of rats with testicular torsion
Künye
TAŞCI, A., UĞURALP, S., AKATLI, A. N., ARSLAN, A. K., & KARABULUT, A. B. (2022). Long-term effects of orchiopexy and orchiectomy on the testes of rats with testicular torsion. Journal of Pediatric Urology.Özet
Introduction: Ischemia/reperfusion injury occurs after testicular torsion, levels of free oxygen
radicals and inflammatory cytokines are increased in both the torsional and contralateral
testis, leading to testicular injury.
Objective: The present study investigated whether orchiopexy or orchiectomy after testicular
torsion was superior in terms of fertility potential in the long term.
Study design: Following 720°, 4h left testicular torsion, orchiectomy or orchiopexy was
performed on 84 rats, which were then sacrificed and evaluated for testicular function at day
1, at 3 months and 6 months (n=14 per group). An additional 14 rats were in the control group.
Results: Follicle stimulating hormone (FSH), luteinizing hormone (LH), and testosterone levels
were significantly lower in the orchiopexy group than the orchiectomy and control groups
after 3 months. However, there were no significant differences in hormone parameters
among the three groups after 6 months. The hormone levels, Johnsen score, seminiferous
tubule diameter, and inducible nitric oxide synthase (iNOS) expression at 3 and 6 months
were not significantly different between the orchiectomy group and controls.
Histopathological analyses at 3 and 6 months indicated significant decreases in Johnsen score
and seminiferous tubule diameter in the ipsilateral testis in the orchiopexy group. At 3
months, the level of iNOS expression in the contralateral testis was significantly lower in the
orchiopexy group than in other groups. At 6 months, however, it was not significantly
different between the orchiopexy and control groups. There were no significant differences
in iNOS expression at 3 or 6 months in the orchiectomy group compared to controls.
Discussion: The ipsilateral testis in the orchiopexy group began to atrophy at 3 months, and
the degree of atrophy became more evident at 6 months. The level of iNOS expression was
low in the bilateral testis at 3 months in the orchiopexy group, and sperm in the contralateral
testis were not yet functionally healthy. The level of iNOS expression in the ipsilateral testis
decreased further at 6 months in the orchiopexy group, while that in the contralateral testis
returned to the normal level.
Conclusion: Testicular functions were restored faster after orchiectomy compared to
orchiopexy following testicular torsion. However, follow-up of the rats for 6 months demonstrated that orchiopexy or orchiectomy procedures conducted on the testicular
torsion had no effect on future fertility potential after 4 hours of torsion.