The effects of increased intraabdominal pressure on testicular blood flow, oxidative stress markers, and morphology

Abstract

Background This study was carried out to evaluate the effects of increased intraabdominal pressure (IAP) on testicular blood flow (TBF), oxidative stress markers, and morphology. Methods Twenty-four Sprague-Dawley rats weighing 300 to 350 g were allocated randomly into 3 groups consisting of 8 animals each: A, gasless (control); B, 10 mm Hg IAP with CO 2 pneumoperitoneum for 60 minutes; and C, 20 mm Hg IAP with CO 2 pneumoperitoneum for 60 minutes. Testicular blood flow was studied using the Doppler technique. In the 10 and 20 mm Hg IAP groups, time points of TBF measurements were defined as follows: TBF baseline, 10 minutes before insufflation; TBF 10min, 10 minutes after pneumoperitoneum; TBF 50min, 50 minutes after pneumoperitoneum; and TBF reperfusion, 10 minutes after pneumoperitoneum deflation. To evaluate the changes in oxidative stress, we assayed the malondialdehyde (MDA) levels of testicular tissues. A 4-level grading scale was used to quantify histologic injury. Results For both testes of each rat, TBF 10min, TBF 50min, and TBF reperfusion values of each group were separately evaluated according to their TBF baseline value percentages. The results revealed no significant differences for each time point of TBF measurements between the right and left testes in any group. Pneumoperitoneum caused a significant decrease in TBF at the 10th and 50th minutes of pneumoperitoneum, both in the 10 and 20 mm Hg IAP groups, compared with their baseline values. TBF reperfusion values in both groups were also lower than their baseline values. We determined that mean TBF 10min and TBF 50min values decreased significantly in the 20 mm Hg IAP group compared with the 10 mm Hg IAP group, despite there being no significant difference in their mean TBF reperfusion values. Mean MDA levels were significantly increased in both the 10 and 20 mm Hg IAP groups compared with those of the control group for the right and left testes. However, there was no significant difference between the mean MDA levels in these first 2 groups. The histologic injury score was significantly increased in both the 10 and 20 mm Hg IAP groups compared with the control group; however, there was no difference in the scores between these first 2 groups. Conclusions We demonstrated in an animal model that abdominal deflation after IAP of 10 and 20 mm Hg for 60 minutes causes testicular hypoperfusion, free radical production, and subsequent testicular damage.