Unilateral Testicular Disease: Effect on the Contralateral Testis (Morphometric Study)

Janetschek, G.; Heilbronner, R.; Schachtner, W.; Rohr, H. P.; Mikuz, Gregor; Bartsch, Georg

doi:10.1016/s0022-5347(17)43407-0

Cited by 7 publications

(5 citation statements)

References 29 publications

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“…This is consistent with previous results from this lab [8,17] as well as many others (see [17] for review, [19,20]), but is in contrast with the oft-repeated notion that contralateral effects result from ipsilateral torsion (see [21] for review, [22,23]). …”

Section: Discussionsupporting

confidence: 92%

Spermatic Cord Torsion: Loss of Spermatogenesis Despite Return of Blood Flow1

Turner

Brown

1993

Biology of Reproduction

164

129

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Previous work in animal models has recapitulated and refined the clinical observation that longer periods of testicular torsion are associated within increased damage to the testis. Minimum times of damage-inducing torsion have not been established, however, nor has it been established to what degree blood flow returns to the testis on examination several hours or days after the torsion repair. Adult male rats were subjected to 0.5-h or 1.0-h 720 degrees torsion and examined for effects on testis weight, histology, and daily sperm production (DSP). None of the parameters examined were affected by 0.5-h, but all were affected by 1.0-h torsion. In a subsequent experiment, adult rats were subjected to unilateral, 1-h, 720 degrees torsion, and bilateral testicular blood flow as measured by radiolabeled microsphere distribution was determined during torsion and 4 h, 24 h, 2 days, 7 days, 15 days, and 30 days after repair of torsion. Ipsilateral testicular blood flow was reduced 94% during torsion. Blood flow was not significantly different from control or contralateral values by 4 or 24 h after repair of torsion. In spite of this return of blood flow, testis weights were significantly reduced by half by 7 days after torsion repair and spermatogenesis was clearly disrupted upon histological examination 30 days after torsion repair. Increasing the time of torsion to 2 or 4 h did not inhibit return of blood flow to the testis as measured 48 h after torsion repair. Unless the testis is infarcted, testicular blood flow in the rat model returns to normal after torsion repair.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionsupporting

confidence: 92%

Spermatic Cord Torsion: Loss of Spermatogenesis Despite Return of Blood Flow1

Turner

Brown

1993

Biology of Reproduction

164

129

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“…Even if quantitative methods are used to evaluate such tissues, the evaluation fails to mean anything. By combining morphometry with fixation by means of testicular perfusion, exact and reproducible results can be achieved [14]. In our rat model, no influence of unilateral experimental testicular torsion on the contralateral testis could be detected either shortly after torsion or after a long interval.…”

Section: Discussionmentioning

confidence: 71%

“…Also, using quantitative histologic techniques, no contralateral damage was demonstrable 2 months after torsion [14]. These observations do not support the contention that Offprint requests to: G. Janetschek, Klinik fiir Urologic, Anichstrasse 35, A-6020 Innsbruck, Austria there is a long-term effect of torsion on the contralateral side, but they do not exclude the possibility of a transitory disturbance that is followed by regeneration.…”

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confidence: 75%

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Experimental testicular torsion: time course of the effect on the contralateral testicular histology

et al. 1991

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Since fertility is decreased in patients with unilateral torsion, a detrimental influence of the damaged tesis on the contralateral side has been postulated. In previous studies, we could not detect such an effect 2 months after the application of torsion. The present study was designed to search for an early defect that may be followed by regeneration as well as for a defect that appears only later. At 2 weeks, 4 months and 7 months after unilateral testicular torsion and sham operation, respectively, in rats, both testes were examined. By means of morphometry, the different testicular components of the contralateral testes were quantified, but neither early nor late damage could be detected. Therefore, despite some other conflicting studies, we do not believe that contralateral testicular damage necessarily occurs after torsion. The decreased fertility may be explained by an immunologic attack on the spermatozoa on their way out of the genital tract.There is general consensus that fertility is impaired after unilateral testicular torsion and this has also been our own experience [3]. Since one healthy testis suffices to maintain the reproductive potential, either pre-existing or subsequent damage to the contralateral side must be considered [10]. Recently, the theory of contralateral testicular damage after torsion has found widespread acceptance, and many arguments favouring underlying autoimmune orchitis have been presented [4,5,7, 11,19].In contrast, we could not observe any influence on the exocrine and endocrine testicular function exceeding the effect of unilateral castration at 2 months after the application of unilateral testicular torsion in rats [13]. Also, using quantitative histologic techniques, no contralateral damage was demonstrable 2 months after torsion [14]. These observations do not support the contention that Offprint requests to: G. Janetschek, Klinik fiir Urologic, Anichstrasse 35, A-6020 Innsbruck, Austria there is a long-term effect of torsion on the contralateral side, but they do not exclude the possibility of a transitory disturbance that is followed by regeneration. Therefore, the present study was undertaken to elucidate the time course of the presumed contralateral damage. Materials and methods AnimalsA total of 60 sexually mature male Wistar albino rats -varying in weight from 460 to 670 g at the end of the study -were used for the present investigation. The animals were housed in a temperature-and light-controlled room and were maintained on pellet food and water ad libitum. Experimental designThe animals were divided into 3 groups of 20 rats each. Each group was subdivided, and either unilateral testicular torsion or a sham operation as control (right scrotal incision and exposure of the testis) was performed in 10 animals each. Contralateral and ipsilateral testicular histology were investigated after an interval of 2 weeks (group I), 4 months (group II) and 7 months (group III) following the application of torsion. All animals were the same age when the testes were removed fo...

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“…Patienten mit einer Hodentorsion müssen, unabhängig davon, ob der torquierte Hoden orchiektomiert oder belassen wird, mit einer vorübergehenden oder irreversiblen Fertilitätsstörung rechnen. Dieses Phänomen wurde mit dem Freisetzen schädigender Substanzen (13), mit einer immunologischen Reaktion (9,17,18,20), mit einer Akkumulation von Neurotransmittern (23), sowie mit der Annahme von bereits vorbestehenden morphologischen Defekten beider Hoden (12) Nach unseren Untersuchungen ist in Übereinstimmung mit Schütte et al (23) die Zeitspanne zwischen Torsion und Operationszeitpunkt für die spätere "Fertilität" nicht von Bedeutung, wobei das Torsionsausmaß von uns retrospektiv nicht beurteilt werden konnte.…”

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