MP26-05 INTRACOMPARTMENTAL PRESSURE AS A PREDICTOR OF INTRATESTICULAR BLOOD FLOW: A RAT MODEL

Abstract

You have accessJournal of UrologyPediatrics: Testis, Varicocele & Stones1 Apr 2014MP26-05 INTRACOMPARTMENTAL PRESSURE AS A PREDICTOR OF INTRATESTICULAR BLOOD FLOW: A RAT MODEL Matthew Watson, Donald Bartkowski, and Nathan Nelson Matthew WatsonMatthew Watson More articles by this author , Donald BartkowskiDonald Bartkowski More articles by this author , and Nathan NelsonNathan Nelson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.893AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Testicular torsion is a surgical emergency as prolonged ischemia to the testis may result in irreversible cell death and testicular atrophy. Following detorsion of the testis an ischemic-reperfusion induced compartment syndrome may develop resulting in testicular arteriolar occlusion and loss of perfusion. Using a rat model for testicular compartment syndrome, we measured testicular intraparenchymal blood flow velocity as a function of increasing tunica albuginea intracapsular testicular pressure in order to define a critical vascular stop flow pressure (SFP). METHODS Forty-nine Sprague Dawley rats were divided into seven cohorts, each cohort receiving the same treatment. Experimental procedures were performed on the right then left testicle. The testicle of each rat was delivered from the scrotum and size measurements were made. An intracompartment pressure monitor needle was inserted into the testis to record basal intracompartmental pressure. The monitor needle was left in the testicle for the duration of the procedure. Flow measurements of the testis were collected using a 12-14 Hz ultrasound probe while Color-Flow (CF) and Pulse-Wave (PW) Doppler modalities were used concurrently to monitor vascular flow within the testis. Following baseline pressure and velocity measurements, saline infusion through the compartment monitor via a pressure infusion pump was performed. The testicular intracompartmental pressure was increased in 5 mmHg increments via pump infusion. Following each 5 mmHg increase, intratesticular vascular blood flow and velocities were recorded using CF and PW respectively. Saline infusions were made and velocity measurements were taken until loss of CF images indicated a complete absence of flow. RESULTS Using a paired t-test (p<0.0001) the mean CF pressure of occlusion was found to be 52.17 mmHg (95% CI, 49.57-54.77) while the PW pressure of occlusion was calculated to be 36.34 mmHg (95% CI, 33.90-38.77). Regression analysis of PW vs CF revealed a slope of 0.6960±0.09112, a y-intercept of 0.02427±4.824 and an x-intercept of -0.03486 providing evidence that both modalities measured similar flow changes. CONCLUSIONS To our knowledge this study is the first to characterize a SFP within the testicular parenchyma resulting from an increased intracompartmental pressure. Due to probe sensitivity limitations, CF appears to provide the most precise mean pressure of occlusion of 52.17 mmHg. Further work to determine which of the two intratesticular pressures correlates with parenchymal loss is ongoing. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e252-e253 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Matthew Watson More articles by this author Donald Bartkowski More articles by this author Nathan Nelson More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...