Can Testicular Fibrosis Due to Testicular Torsion Be Prevented with Ketotifen As A Mast Cell Stabilizer?

Abstract

Background: In infertility clinics, biopsies taken from undescended atrophic testicles showed increased mast cells which are not found in normal testis. So, it was thought that mast cells could have a contributing effect on fibrosis leading to testicular atrophy. Our aim of the study is to investigate the efficacy of ketotifen, which is a mast cell stabilizer, on the prevention of testicular fibrosis in a testicular torsion-detorsion rat model. Materials and Methods: Thirty rats were divided into three equal groups, each consisting of ten animals. In group A; the testicular tissues were only separated from the gubernaculum without torsion (Sham). In group B, detorsion was performed after four hours of testicular torsion in the right testes. In group C, after four hours of right testicular torsion and detorsion, the rats were taken ketotifen as a medical treatment (1 mg/kg/day, orally started on the first day, continued for three weeks). The rats were sacrificed under anesthesia, three weeks after surgery to determine testicular fibrosis. Histopathologic evaluation was performed with Johnsen's score in both testes as a control evaluation. Results: According to Johnsen score, median values were found 9.9 in group A; 3.7 in group B, and 8.4 in group C. Johnsen score was found significantly high in group C (with ketotifen) when compared with the other groups (p< 0.05). When we made a pairwise comparison, we found a significant difference between the group's A and B (p=0.0001), the group’s B and C; (p=0.039), and the group’s A and C (p=0.006). Conclusion: We found that ketotifen had a preventing effect against testicular fibrosis as a mast cell stabilizer in the testis torsion-detorsion rat model.