Abstract

Testicular torsion causes migration of neutrophils to the ischemic region and formation of free oxygen radicals that have a critical effect on ischemic reperfusion (I/R) injury. Udenafil is a selective, strong, and reversible inhibitor of phosphodiesterase type enzyme. In our study, we evaluate the protective effect of udenafil against reperfusion injury due to I/R. Twenty-one male, adult, Wistar-Albino rats aged 8 months were randomly divided into three groups; sham, I/R, and I/R+udenafil. One hour before the detorsion operation, the sham and I/R groupssaline, and I/R+udenafil groups were administered 2 mg/kg udenafil intraperitoneally. Blood samples were collected to evaluate the inflammatory mediators. Spermatogenic factors were evaluated according to Johnsen criteria. Histopathological and molecular parameters from all groups were compared. Mean values of TNF-α and IL-1β in venous blood samples were calculated. We observed that TNF-a values were statistically significantly increased in the I/R group than those in sham groups, and these values were decreased with udenafil treatment Furthermore, the glutathione peroxidase (GPx) level was statistically significantly decreased in the I/R group, and treatment with udenafil prevented this decrease. Evaluation of spermatogenesis using the Johnsen scoring system showed no statistically significant difference in mean scores between the groups. We concluded that deterioration of biochemical and histopathological parameters are reversed, and injury due to I/R in testicle tissue may be decreased with udenafil treatment. Results of this experimental study show that efficacy of the udenafil treatment in testis torsion should be investigated.

Highlights

  • The torsion of testicle and spermatic cord are urologic emergencies in newborns, children, and adolescents

  • We evaluate the protective effect of udenafil against reperfusion injury due to ischemic reperfusion (I/R)

  • We observed that tumor necrosis factor (TNF)-a values were statistically significantly increased in the I/R group than those in sham groups, and these values were decreased with udenafil treatment the glutathione peroxidase (GPx) level was statistically significantly decreased in the I/R group, and treatment with udenafil prevented this decrease

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Summary

Introduction

The torsion of testicle and spermatic cord are urologic emergencies in newborns, children, and adolescents. The incidence is about 1/4000 until 25 years old [1]. The survival rate of de-torsioned testes is about 48-88% [2]. Spermatogenic functions are not well-known in these operated testes. It is indicated that a simple orchiectomy has to be done in late cases, which may cause infertility due to loss of function in the contralateral testes [3]. We do not clearly know how and when irreversible changes begin in the testes, intervention or detorsion surgery is recommended to be done in 4-6 h [4]

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