Abstract
Ovarian torsion is one of the most common gynecological emergencies, which especially affects women of reproductive age. We aimed to evaluate the effect of Ginkgo biloba (GB) supplementation in ovarian ischemia/ reperfusion injury in an experimental torsion/de-torsion rat model. This study was carried out in the Ege University Faculty of Medicine in Izmir, Turkey. Thirty mature female Sprague-Dawley albino rats were randomly divided into 5 groups: in Group 1 (control), the abdominal wall was only opened and closed; in the torsion group (Group 2), ischemia was induced for 3 h, using atraumatic vascular clips to create a torsion model; in the torsion/GB group (Group 3), the rats were given 80 mg/kg (oral gavage) of GB 30 min before torsion was induced and the torsion model was formed; in the torsion/de-torsion group (Group 4), the rats underwent 3 h of ischemia and then the vascular clips were removed and reperfusion took place for 3 h; in the torsion/de-torsion/GB group (Group 5), the rats underwent 3 h of ischemia followed by GB (oral gavage) 30 min prior to a 3-h reperfusion period. Ovarian tissue damage was evaluated by a histopathological scoring system. Ovarian tissue malondialdehyde (MDA) and plasma pentraxin-3 were measured. In comparison with the sham group, both the torsion and torsion/de-torsion groups had significantly higher scores for follicular degeneration, vascular congestion, edema, hemorrhage, and leukocyte infiltration. Ginkgo biloba significantly decreased these scores in both groups. Ovarian malondialdehyde and plasma pentraxin 3 were significantly higher both in the torsion and torsion/de-torsion groups compared with the sham group. Ginkgo biloba decreased these levels significantly both in the torsion/GB and torsion/de-torsion/GB groups. Supplementing GB during a surgical procedure decreases ischemia/reperfusion injury to an ovary in an experimental rat model based on histopathological parameters, tissue malondialdehyde, and plasma pentraxin-3 levels.
Highlights
Ovarian torsion is defined as a partial or total rotation of the ovary, the fallopian tube, or both around its vascular axis
We aimed to evaluate the effect of Ginkgo biloba (GB) supplementation in ovarian ischemia/ reperfusion injury in an experimental torsion/de-torsion rat model
Thirty mature female Sprague-Dawley albino rats were randomly divided into 5 groups: in Group 1, the abdominal wall was only opened and closed; in the torsion group (Group 2), ischemia was induced for 3 h, using atraumatic vascular clips to create a torsion model; in the torsion/GB group (Group 3), the rats were given 80 mg/kg of GB 30 min before torsion was induced and the torsion model was formed; in the torsion/de-torsion group (Group 4), the rats underwent 3 h of ischemia and the vascular clips were removed and reperfusion took place for 3 h; in the torsion/de-torsion/GB group (Group 5), the rats underwent 3 h of ischemia followed by GB 30 min prior to a 3-h reperfusion period
Summary
Ovarian torsion is defined as a partial or total rotation of the ovary, the fallopian tube, or both around its vascular axis. The compression of the ovarian vessel obstructs lymphatic and venous outflow first, and subsequently arterial inflow. The blockage of the lymphatic and venous systems leads to ovarian edema, resulting in enlargement of the ovary. Increased ovarian stromal pressure blocks the arterial blood supply, which leads to ovarian ischemia and results in necrosis of the ovarian tissue, infarction, and local hemorrhage. It is the 5th-leading cause of surgical emergencies with a prevalence of 2.7–3%.1. Increased infertility treatment tends to raise the incidence rate iatrogenically. The incidence rate rises dramatically to 6% after ovarian stimulation and reaches as high as 16% in cases of ovarian hyperstimulation syndrome.[2]. Ovarian torsion is one of the most common gynecological emergencies, which especially affects women of reproductive age
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