Prevention of the harmful effects of free oxygen radicals by using N-acetylcysteine in testicular torsion

Abstract

Testicular torsion is a urological emergency both in childhood and in adult life. Many studies on experimental testicular torsion have demonstrated biochemical and pathological ischemia-reperfusion injury and the efficacy of some drugs have been investigated to prevent this damage. N-acetylcysteine (NAC) promotes glutathione synthesis and acts as a glutathione precursor because of the fact that it increases the glutathione-reductase activity by transporting sulfhydryl groups. In this experimental study, the authors aimed to investigate the effectiveness of NAC in preventing ischemia-reperfusion injury following testicular torsion and detorsion. For this experimental study, 36 albino Wistar-male rats were used. The rats were randomly divided into 4 groups: sham (n=8), ischemia-reperfusion(n=8), ischemia-NAC -reperfusion (n=10), and ischemia-NAC-reperfusion-NAC(n=10) groups. Two hours of torsion and 4h of detorsion were created in the left testis. After 4h of detorsion, the rats were sacrificed. Each tissue was divided into two sections for biochemical and pathological examinations. There was a statistically significant difference between the study groups in terms of the total-sulfhydryl level, nitric oxide level, and the malondialdehyde values. Histopathological examination revealed that NAC was effective in preventing reperfusion injury in the testisbut ineffective in preventing the reduction in the spermatid count. The results of this experimental study support that NAC can histopathologically maintain the structure of seminiferous tubules against ischemis reperfusion injury and prevent damage to the germinative cells. However, it was unable to prevent the reduction in spermatid count. There was no significant difference in the prevention of ischemia-reperfusion injury between NAC administration during the first hour of ischemia and NAC administration during reperfusion. Although NAC can prevent tissue damage from ischemia reperfusion injury, it is not effective against the reduction in the spermatid count. N-acetylcysteine may be biochemically effective in preventing ischemia-reperfusion injury after testicular torsion and detorsion. NAC is a readily available and easy to use agent that can be used during testicular ischemia.