The Effect of Testicular Torsion on the Contralateral Testis

Abstract

It has been reported that patients with history of testicular torsion experienced diminished fertility. This study was instituted to evaluate the effect of unilateral testicular torsion on contralateral testicular histology. Mature Sprague Dawley rats were divided into 10 experimental groups, 2 of which (10 animals each) were used for experimental controls. Group 1 underwent a sham procedure consisting of a right hemi-scrotal incision. Group 2 underwent a sham operation in which the right hemi-scrotum was opened and 2 sutures were placed through the testicular parenchyma. Group 3 animals underwent right testicular torsion with fixation to the scrotal wall. Ten days later contralateral testicles were examined. Testicular torsion was demonstrated to cause contralateral testicular damage. The sham animals had no contralateral changes. The effect of therapy (detorsion vs. orchiectomy) was then studied. Group 4 animals underwent torsion followed by detorsion at 24 hours. Group 5 animals underwent torsion followed by orchiectomy at 24 hours. Detorsion after 24 hours offered no protection from the contralateral testicular damage. Orchiectomy of the torsed testicle appeared to protect the contralateral testes from damage. A further set of experiments was carried out to assess the ability of immunologic suppression to protect against contralateral testicular damage. Group 6 animals received anti-lymphocyte globulin without testicular torsion. There was no evidence of testicular damage. Group 7 animals underwent torsion with perioperative treatment employing anti-lymphocyte globulin. This did not afford protection to the contralateral testicle. In attempt to enhance the immunologic suppression splenectomy was added to the regimen. Group 8 animals underwent subcutaneous torsion. Control group 9 underwent orchiectomy followed by a splenectomy on day 3. There were no contralateral testicular alterations in the control group. Group 10 animals underwent testicular torsion with peri-operative anti-lymphocyte globulin and splenectomy on day 3. This immunosuppressive regimen prevented contralateral testicular damage. These studies indicate that testicular torsion will cause contralateral testicular damage. These contralateral alterations can be avoided by orchiectomy or immunologic suppression. Detorsion carried out after 24 hours of torsion offered no protection from this contralateral damage.