Abstract
To assess the incidence of testicular necrosis/atrophy immediately after 1 to 4 hours of 1,080-degree torsion of the spermatic cord, and 60 days after detorsion of the spermatic cord. 42 rats were divided in 7 groups. Except for the control group, surgical torsion of the right spermatic cord was performed in all groups (T0). After 1, 2, or 4 hours of torsion, each group underwent either ipsilateral orchiectomy (groups OT1, OT2, and OT4), or detorsion of the spermatic cord and observation for 60 days (groups DT1, DT2, and DT4), before they were evaluated for the presence of testicular necrosis/atrophy. Only one rat (5.5%) in groups OT1, OT2, and OT4 had testicular necrosis, in comparison with six rats (33.3%) in groups DT1, DT2, and DT4 (p=0.04). The incidence of testicular necrosis/atrophy was not different between subgroups T1, T2, and T4, and the control group (p>0.05). There was, however, a tendency toward greater incidence of necrosis/atrophy in the rats in group DT4. The incidence of testicular necrosis/atrophy immediately after 1 to 4 hours of 1,080-degree torsion of the spermatic cord is 5.5%, in comparison with 33.3% sixty days after detorsion of the spermatic cord.
Highlights
IntroductionTorsion of the spermatic cord (testicular torsion) is an emergency that results from rotation of the testis and epididymis around the axis of the spermatic cord
Torsion of the spermatic cord is an emergency that results from rotation of the testis and epididymis around the axis of the spermatic cord
The incidence of testicular necrosis/atrophy was not different between groups DT1, DT2, and DT4, and the control group, there was a tendency toward higher incidence of testicular necrosis/atrophy in group DT4 (Table 2-B)
Summary
Torsion of the spermatic cord (testicular torsion) is an emergency that results from rotation of the testis and epididymis around the axis of the spermatic cord. The annual incidence of testicular torsion is between one in 4,000 males and one in 158 males younger than 25 years, with peaks of incidence occurring in neonates and adolescents entering puberty.[1,2] Immediate diagnosis and prompt surgical treatment are important to avoid permanent damage to the testis. Experimental models of testicular torsion are valuable tools to evaluate the relationship between the degree and duration of torsion with the blood flow and resultant damage to the torsed testes. With 720-degree of torsion, several studies have reported reduction in testicular blood flow varying from 61.7% to 100%;5-8 with ischemic injury after periods of time as diverse as 1 hour and 8 hours of torsion.[7,8,9,10,11]
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