Abstract
BackgroundTorsion of the testis is an urgent surgical condition that endangers the viability of the gonad and the fertility of the patient. Our aim was to assess potential autoimmune processes and hormonal abnormalities in boys operated on due to that illness.MethodsThe authors evaluated the levels of antibodies against sperm and Leydig cells, concentrations of follicle-stimulating, luteinizing and anti-Müllerian hormone, testosterone, oestradiol and vascular endothelial growth factor in the serum in 28 boys operated on due to torsion of the testis. Patients’ sexual maturity was assessed according the Tanner scale (group G1, G4 and G5).ResultsNo antibodies against sperm or Leydig cells were found in the serum. Statistically significant differences in follicle-stimulating and anti-Müllerian hormone concentrations were observed in the G1, and they were higher in the study than in the control group. There were no statistically significant differences in luteinizing hormone, testosterone, oestradiol and vascular endothelial growth factor concentrations in the study group or control group. Testosterone concentration was unrelated to total testicular volume.ConclusionsResults did not confirm the autoimmune process in boys with torsion of the testis. The pituitary–testis axis seems to have sufficient compensation capabilities. However, study results suggest that primary gonadal dysfunction may predispose to torsion.ImpactSignificant differences exist between the literature data and own results on the formation of antibodies and hormonal changes due to testicular torsion in boys.It is a novel, prospective study on antibodies against sperms and Leydig cells in the serum and on hormonal processes occurring as a result of the testicular torsion from the prenatal period to the adolescence with division into pubertal groups.The study has revealed sufficient compensation capabilities of the pituitary–testis axis and no autoimmune process in boys with torsion of the testis.
Highlights
Torsion of the testis (TT) is an urgent surgical condition involving incomplete or complete and single or multiple rotation(s) of the spermatic cord around a long axis with impaired blood flow through the testis.[1,2] It is the second most common cause of “acute scrotum” conditions in boys after torsion of the appendix testis.[3,4] According to Arap et al.[5] and Lee et al.,[6] the incidence of TT in the world’s male population under 25 years of age ranges from 3 to 25/100,000
No antibodies against sperm nor Leydig cells were found in the serum of patients from the study and control groups
No antibodies against sperm or Leydig cells were found in the serum in our study group or the control group
Summary
Torsion of the testis (TT) is an urgent surgical condition involving incomplete or complete and single or multiple rotation(s) of the spermatic cord around a long axis with impaired blood flow through the testis.[1,2] It is the second most common cause of “acute scrotum” conditions in boys after torsion of the appendix testis.[3,4] According to Arap et al.[5] and Lee et al.,[6] the incidence of TT in the world’s male population under 25 years of age ranges from 3 to 25/100,000. Our aim was to assess potential autoimmune processes and hormonal abnormalities in boys operated on due to that illness. METHODS: The authors evaluated the levels of antibodies against sperm and Leydig cells, concentrations of follicle-stimulating, luteinizing and anti-Müllerian hormone, testosterone, oestradiol and vascular endothelial growth factor in the serum in 28 boys operated on due to torsion of the testis. Significant differences in folliclestimulating and anti-Müllerian hormone concentrations were observed in the G1, and they were higher in the study than in the control group. There were no statistically significant differences in luteinizing hormone, testosterone, oestradiol and vascular endothelial growth factor concentrations in the study group or control group. CONCLUSIONS: Results did not confirm the autoimmune process in boys with torsion of the testis. Study results suggest that primary gonadal dysfunction may predispose to torsion
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