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Li Y, Chen Q, Chen J, Lin S, Zhong H. Segmental testicular infarction in adolescent:experience of new treatment and testicular function monitoring. Heliyon 2024; 10:e33775. [PMID: 39040349 PMCID: PMC11261842 DOI: 10.1016/j.heliyon.2024.e33775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/24/2024] Open
Abstract
Segmental testicular infarction is a relatively rare acute or subacute condition that is often overlooked in the differential diagnosis of testicular pain. Ultrasound is highly sensitive in detecting testicular damage. Combining testicular tumour markers with MRI can effectively identify tumours and infarctions. Conservative treatment programs for adolescents suggest that testicular function should be monitored. We report the case of a 12-year-old boy with testicular infarction who was treated with antibiotics, dexamethasone, and vitamin C. We monitored reproductive hormones, inhibin B, anti-Müllerian hormone, and testicular volume to assess the patient's testicular function. LH increased 3.02 fold on day 14 and 3.8 fold on day 42; T increased 6.92 times on day 14 and 7.95 fold on day 42; inhibin B increased 2.72 fold on day 14 and 4.06 fold on day 42; the left testicular volume increased 1.14 fold on day 42; the right testicular volume decreased by 8 %; and the infarct area decreased by 71 %. This case study demonstrated the effectiveness of conservative treatment with antibiotics, dexamethasone, and vitamin C for segmental testicular infarction. Close monitoring of testicular function is essential for optimal management of this rare condition in adolescent patients.
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Affiliation(s)
- Yan Li
- Department of Pediatrics Surgery, Women and Children's Hospital of Ningbo University, Ningbo, China
| | - Qiang Chen
- Department of Biochemistry and Molecular Biology, Health Science Center, Ningbo University, Ningbo, Zhejiang, 315211, China
| | - Jinliang Chen
- Department of Radiology, Women and Children's Hospital of Ningbo University, Ningbo, China
| | - Shaoyu Lin
- Department of Ultrasound, Women and Children's Hospital of Ningbo University, Ningbo, China
| | - Hongji Zhong
- Department of Pediatrics Surgery, Women and Children's Hospital of Ningbo University, Ningbo, China
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Ganjiani V, Bigham-Sadegh A, Ahmadi N, Divar MR, Meimandi-Parizi A, Asude M. The potential prophylactic and therapeutic impacts of niacin on ischemia/reperfusion injury of testis. J Pediatr Urol 2024; 20:281.e1-281.e7. [PMID: 38212166 DOI: 10.1016/j.jpurol.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 12/17/2023] [Accepted: 01/02/2024] [Indexed: 01/13/2024]
Abstract
INTRODUCTION The testicular ischemia-reperfusion (I/R) injury is characterized by the excessive aggregation of un-scavenged reactive oxygen species, leading to the heightened levels of oxidative stress. This phenomenon plays a pivotal role in the pathophysiology of testicular torsion damage. OBJECTIVE The current study aimed to detect the prophylactic and therapeutic effects of niacin on testicular I/R injury. STUDY DESIGN Twenty-four healthy adult male Sprague Dawley rats were randomly allocated into three groups as follows: (1) sham group, (2) torsion/detorsion (T/D) group, and (3) treatment group which received 200 mg/kg niacin along with testicular T/D. Torsion/detorsion was induced by 2 h of torsion followed by 10 days of reperfusion period. In the treatment group, niacin was injected 30 min before the reperfusion period intraperitoneally and continued for 10 days by oral gavage. RESULTS T/D was associated with marked decreases in terms of sperm count, viability, and kinematic parameters versus the sham group (P < 0.05), which niacin significantly reverted the kinematic parameters (P < 0.05). I/R injury caused a significant increase in the number of abnormal epididymal sperms compared to the sham group (P < 0.05). Niacin decreased the epididymal sperm abnormality significantly compared to the T/D group (P < 0.05). Tissue abnormalities in T/D group, such as edema, hyperemia, inflammation, and necrosis were completely visible histopathologically, while the histological changes in the niacin-treated group were better than those in the T/D group. Regarding the pathological parametric evaluations, I/R injury significantly reduced the mean testicular biopsy score (MTBS), germinal epithelial cell thickness (GECT), and mean seminiferous tubular diameter (MSTD), and increased the tubular hypoplasia/atrophy (THA) compared to the sham group (P < 0.05), which niacin treatment significantly improved the MTBS and GECT compared to the T/D group (P < 0.05). T/D significantly increased the oxidative stress index (OSI) and lipid peroxidation (MDA) (P < 0.05). Niacin significantly reduced the OSI and MDA levels compared to the T/D group (P < 0.05). DISCUSSION The current study found that niacin has preventive/therapeutic effects against the elevation of oxidative stress markers and depletion of antioxidants during I/R injury. Following administration of niacin, a reduction in histologic injury was observed in rats. In our study, we showed the antioxidant properties of niacin and its capacity to protect against I/R damage. CONCLUSION The findings of the present investigation revealed that niacin, as an antioxidant agent, can suppress the oxidative stress induced by testicular I/R injury, and can be used as a supplementary agent in the treatment of those undergoing testicular torsion surgery.
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Affiliation(s)
- Vahid Ganjiani
- Department of Clinical Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Amin Bigham-Sadegh
- Department of Clinical Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Nasrollah Ahmadi
- Department of Pathobiology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran.
| | - Mohammad-Reza Divar
- Department of Clinical Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | | | - Mohammad Asude
- Department of Clinical Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
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Zhu CL, Wang L, Zhao XQ, Yang R, Zhang BY, Zhao YY, Xia XJ, Zhang HH, Chen SJ, Jiang JQ, Hu JH, Zhang GP, Bai YY, Lei LC, Zhang XM. Antimicrobial peptide MPX attenuates LPS-induced inflammatory response and blood-testis barrier dysfunction in Sertoli cells. Theriogenology 2022; 189:301-312. [PMID: 35842953 DOI: 10.1016/j.theriogenology.2022.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/20/2022] [Accepted: 07/03/2022] [Indexed: 11/20/2022]
Abstract
Orchitis accounts for a high proportion of male animal reproductive disorders. Hence, it is urgent to identify drugs for the prevention and treatment of orchitis. Antimicrobial peptides (AMPs) are currently recognized as one of the most promising alternatives to antibiotics. However, the protective effects of AMPs on lipopolysaccharide (LPS)-induced orchitis have not been reported. In this study, we developed an LPS-induced orchitis model in which primary bovine Sertoli cells were used as model cells. MPX was indicated to effectively reduce the inflammatory response of Sertoli cells. MPX attenuated the gene expression of the proinflammatory cytokines TNF-α, IL-6 and IL-1β by suppressing the MAPK pathway, especially the phosphorylation of p38 and ERK. MPX also decreased the oxidative stress response caused by LPS and upregulated Occludin and Claudin-1 expression, thereby maintaining the integrity of the blood-testis barrier. Moreover, we found that MPX inhibited apoptosis in Sertoli cells. In a mouse model, we found that MPX significantly inhibited the disruptive effects of LPS, reducing seminiferous epithelium damage, vacuolations, hyperplasia, and apoptosis in spermatogenic cells and rescuing spermatogenesis. In addition, the expression of inflammatory factors such as IL-1β, IL-18, IL-6 and TNF-α was decreased after MPX treatment in the mouse testes. MPX had no effect on other organs in mice, indicating its safety. This study was undertaken to investigate how MPX regulates the inflammatory response in Sertoli cells and provide a reference for the clinical prevention and treatment of male animal orchitis.
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Affiliation(s)
- Chun-Ling Zhu
- College of Veterinary Medicine, Jilin University, Changchun, 130000, China; College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology, Xinxiang, 453003, China.
| | - Lei Wang
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology, Xinxiang, 453003, China.
| | - Xue-Qin Zhao
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology, Xinxiang, 453003, China
| | - Rui Yang
- College of Veterinary Medicine, Jilin University, Changchun, 130000, China
| | - Bo-Yang Zhang
- College of Veterinary Medicine, Jilin University, Changchun, 130000, China
| | - Ya-Ya Zhao
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology, Xinxiang, 453003, China
| | - Xiao-Jing Xia
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology, Xinxiang, 453003, China
| | - Hui-Hui Zhang
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology, Xinxiang, 453003, China
| | - Shi-Jun Chen
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology, Xinxiang, 453003, China
| | - Jin-Qing Jiang
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology, Xinxiang, 453003, China
| | - Jian-He Hu
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology, Xinxiang, 453003, China
| | - Gai-Ping Zhang
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450000, China
| | - Yue-Yu Bai
- College of Animal Science and Veterinary Medicine, Henan Institute of Science and Technology, Xinxiang, 453003, China.
| | - Lian-Cheng Lei
- College of Veterinary Medicine, Jilin University, Changchun, 130000, China
| | - Xue-Ming Zhang
- College of Veterinary Medicine, Jilin University, Changchun, 130000, China.
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Can O, Canat L, Eraldemir FC, Acar E, Yildirim F, Sonmez K, Otunctemur A, Altunrende F. Protective effect of oltipraz in testicular ischaemia/reperfusion injury: An experimental study. Andrologia 2022; 54:e14245. [PMID: 34514606 DOI: 10.1111/and.14245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 07/08/2021] [Accepted: 09/01/2021] [Indexed: 01/05/2023] Open
Abstract
Testicular torsion is an emergency urological disease, and the treatment is immediate surgery. Despite emergency surgery, testicular damage may occur due to reperfusion. Therefore, a medical treatment to prevent this damage may be a rational idea. We aimed to evaluate the protective effect of oltipraz in testicular ischaemia/reperfusion damage. Twenty-eight Wistar-Albino rats were randomly divided into four groups. In ischaemia/reperfusion group, testicular torsion was executed, and orchiectomy was done 4 hr after detorsion with no treatment. Second group performed torsion; intraperitoneal 50 mg/kg oltipraz was applied 30 min before detorsion, and orchiectomy was performed 4 hr after detorsion. Third group applied torsion; intraperitoneal 150 mg/kg oltipraz was applied 30 min before detorsion, and orchiectomy was performed 4 hr after detorsion. Last one was the sham group. We evaluated tissue malondialdehyde (MDA), transforming growth factor-β1 (TGF-β1), superoxide dismutase (SOD), reduced glutathione (GSH) and Johnsen testicular biopsy score. There was a significant decrease in TGF-β1, GSH and MDA values in oltipraz treatment groups compared with ischaemia/reperfusion group. Oltipraz treatment has significant protective effect in testicular ischaemia/reperfusion damage. However, more clinical studies are needed to demonstrate appropriate dose and its effects.
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Affiliation(s)
- Osman Can
- Department of Urology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Lutfi Canat
- Department of Urology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Fatma Ceyla Eraldemir
- Department of Biochemistry, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Esra Acar
- Department of Biochemistry, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Funda Yildirim
- Department of Pathology, Faculty of Veterinary Medicine, Istanbul University, Istanbul, Turkey
| | - Kivilcim Sonmez
- Department of Pathology, Faculty of Veterinary Medicine, Istanbul University, Istanbul, Turkey
| | - Alper Otunctemur
- Department of Urology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Fatih Altunrende
- Department of Urology, Prof. Dr. Cemil Tascioglu City Hospital, Istanbul, Turkey
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Histopathologic and histomorphometric evaluation of Dipetalonema evansi infection in camel testicular tissue. J Parasit Dis 2021; 45:959-963. [PMID: 34789978 DOI: 10.1007/s12639-021-01384-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 03/28/2021] [Indexed: 10/21/2022] Open
Abstract
Camels are important sources of milk, meat, wool and leather, and are widely used in transportation in arid and semi-arid areas. But their illnesses, especially parasitic diseases, have not been taken into consideration. The Dipetalonema evansi microfilariae are in the blood. Adult nematode is only dedicated to camels and disrupts spermatic arteries, lung arteries, right atrium, and testicles. This study was carried out on testicular samples of camels infected with D. evansi referred from slaughterhouse. In each of the control and contaminated groups, 5 samples were examined. In this study, in addition to the qualitative description of parasite histopathologic lesions, the spermatogenesis process was evaluated quantitatively including spermatogenesis process, diameter of the seminiferous tubules and Johnsen ranking and compared with the control group. Histopathological examination of infected testis with D. evansi showed lumen obstruction of testicular blood vessels by parasites, hypertrophy of blood vessels, degenerative and necrosis changes in the tubules, decreased spermatogenetic activity, increased interstitial space tubules, destruction of the spermatogenic cells. Also, there was a significant difference in the control and contaminated groups in the parameters of spermatogenesis, diameter of the seminiferous tubules and Johnsen score.
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Long-term protective effects of the combination of intermittent reperfusion and hypothermia on reperfusion injury in an experimental testicular torsion model. J Pediatr Surg 2021; 56:2037-2044. [PMID: 33279218 DOI: 10.1016/j.jpedsurg.2020.11.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/21/2020] [Accepted: 11/21/2020] [Indexed: 01/07/2023]
Abstract
INTRODUCTION There are many significantfactors in testicular injury which determine the prognosis in testicular torsion. Reperfusion injury following detorsion also has a significant effect on testicular injury.This study was planned considering that with the implementation of intermittent reperfusion and hypothermia, reperfusion injury can be reduced, and such an application might have a positive effect on testicular tissue in the long term. MATERIALS AND METHODS Forty adult male rats were divided into five groups as follows: Sham(Sh)(n = 8), Torsion(T)(n = 8), Intermittent reperfusion(IR)(n = 8), Hypothermia(H)(n = 8), and Intermittent reperfusion+hypothermia(IR+H)(n = 8). Except forGroup Sh, the left testicle was taken out of the scrotum in all groups, rotated three times counterclockwise, fixed back in the scrotum, and left for four hours.After four hours, and just before reperfusion, the testicle's detorsion was performed while holding the vascular structures in the proximal part of the torsed segment with an atraumatic vessel clamp, and thus, not allowing reperfusion in Groups T, IR, H, and IR+H. In Group T, the clamp was released immediately. In Group H, an ice-bag cooling was performed around the testis, and the clamp was released when the tissue temperature was reached and kept constant at 4 °C. In Group IR, the clamp was released, allowing reperfusion of five seconds, followed by reclamping, providing an ischemic status for ten seconds; this procedure was repeated ten times. In Group H+IR,an ice-bag cooling was performed around the testis, and the clamp was released when the tissue temperature was reached and kept constant at 4 °C. Then, reperfusion was applied for 5 s, followed by 10 s ischemia with reclamping. This procedure was repeated ten times.Tissue blood flow was provided for60 days of reperfusion in all groups. After 60 days, both testicles were excised under anesthesia in all living rats, and samples ofthe left testicle werereserved for biochemical and pathological examinations. At the end of the procedure, all animals were sacrificed by a high dose of anesthesia. RESULTS It was biochemically and histopathologically determined that the tissues were preserved in the experimental groups compared to Group T, which was statistically significant (p < 0.05).However, no experimental group's superiority over each other was determined both biochemically and histopathologically (p > 0.05). CONCLUSION Our long-term experimental study revealed that all methods were protective in testicular torsion. The authors believe that these methods can be applied in clinical practice because of their ease of application and no additional cost. On the other hand, the results of our study should further be supported by other experimental studies.
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Kohsaka T, Yoneda Y, Yoshida T, Minagawa I, Pitia AM, Iwasawa A, Ikegaya N. Relaxin exerts a protective effect during ischemia-reperfusion in the rat model. Andrology 2021; 10:179-189. [PMID: 34435470 DOI: 10.1111/andr.13096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Testicular torsion, which causes ischemia-reperfusion (IR) injury, is a serious urological emergency that can lead to testicular dysfunction, including infertility, primarily among newborn and pubertal males; thus, effective drugs should be administered during or after ischemia. OBJECTIVES Using a rat model of testicular IR injury, the present study investigated the protective effects of relaxin (RLN) against oxidative stress, testicular dysfunction, inflammation, histological damage, arrested spermatogenesis, and germ cell apoptosis as well as explored the usefulness of RLN as a potential protective drug for IR injury combined with surgical treatment. MATERIALS AND METHODS Male Sprague-Dawley rats were subjected to left testicular ischemia for 2 h, followed by 24 h of reperfusion. They were subsequently divided into three groups: sham, IR, and IR + RLN groups. Porcine RLN (500 ng/h) or saline was infused using an implanted osmotic mini-pump 90 min after inducing ischemia. The RLN dose used herein was that which resulted in serum RLN levels comparable to those in mid-pregnant rats based on previous studies. RESULTS Testicular IR increased germ cell apoptosis and histological damage as well as promoted disorganized and arrested spermatogenesis, accompanied by a significant increase in oxidative stress and inflammation. However, RLN administration ameliorated the adverse consequences associated with IR injury by attenuating oxidative stress and mitigating apoptosis and inflammation. DISCUSSION AND CONCLUSION The study findings clearly demonstrated that RLN exerts a protective effect against IR-induced testicular injury by attenuating oxidative stress, apoptosis, and inflammation, suggesting that RLN together with surgical treatment is a potentially efficacious approach toward ameliorating testicular dysfunction following testicular torsion.
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Affiliation(s)
- Tetsuya Kohsaka
- Department of Applied Life Sciences, Shizuoka University, Shizuoka, Japan
| | | | - Takuya Yoshida
- Department of Clinical Nutrition, University of Shizuoka, Shizuoka, Japan
| | - Itaru Minagawa
- Department of Applied Life Sciences, Shizuoka University, Shizuoka, Japan
| | - Ali M Pitia
- Department of Applied Life Sciences, Shizuoka University, Shizuoka, Japan
| | - Atsushi Iwasawa
- Department of Agricultural and Environmental Science, Gifu University, Gifu, Japan
| | - Naoki Ikegaya
- Department of Medicine, Yaizu Municipal General Hospital, Shizuoka, Japan
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Degirmentepe RB, Altunrende F, Bozkurt M, Merder E, Otunctemur A, Sonmez K, Yildirim F, Ada S, Isman FK, Cekmen MB. Protective effect of liraglutide on experimental testicular ischaemia reperfusion in rats. Andrologia 2021; 53:e14000. [PMID: 33550644 DOI: 10.1111/and.14000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/16/2020] [Accepted: 01/18/2021] [Indexed: 11/29/2022] Open
Abstract
This study was performed to evaluate the effect of liraglutide on experimental testicular ischaemia reperfusion in rats in terms of biochemistry, histopathology and immunohistochemistry. A total of 28 male Wistar-Albino rats were divided randomly into 4 groups: control (7), sham (7), ischaemia-reperfusion (7) and ischaemia-reperfusion + liraglutide (7). Biochemically, Nitric Oxide, Malondialdehyde, Superoxide dismutase, Glutathione peroxidase and Catalase levels were measured in the testis. Apoptosis protease activating factor-1 and inducible nitric oxide synthase activity were evaluated immunohistochemically as well. Statistical analyses were made via the Kruskal-Wallis and Mann-Whitney U tests. In the reperfusion group, CAT and SOD values were increased (p > .05), NO and MDA values were decreased (p < .05) after administration of liraglutide. In addition, GPx values were significantly increased in ischaemia reperfusion + liraglutide administered group compared to reperfusion group (p < .05). Apaf-1 and iNOS activity were significantly decreased with the addition of liraglutide treatment to the ischaemia-reperfusion group (p < .05). First of all, we would like to say that liraglutide treatment is moderately preventive against I/R injury in testicular torsion. The anti-inflammatory, antioxidant and antiapoptotic properties of liraglutide are create a moderately protective effect as we show in this study.
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Affiliation(s)
| | - Fatih Altunrende
- Department of Urology, University of Health Sciences Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Muammer Bozkurt
- Department of Urology, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
| | - Erkan Merder
- Department of Urology, University of Health Sciences Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Alper Otunctemur
- Department of Urology, University of Health Sciences Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Kivilcim Sonmez
- Faculty of Veterinary Medicine, Department of Pathology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Funda Yildirim
- Faculty of Veterinary Medicine, Department of Pathology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Saniye Ada
- Department of Medical Biochemistry, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ferruh K Isman
- Department of Medical Biochemistry, Istanbul Medeniyet University, Istanbul, Turkey
| | - Mustafa B Cekmen
- Department of Medical Biochemistry, Istanbul Medeniyet University, Istanbul, Turkey
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Alawamlh OAH, Flannigan R, Hayden R, Goldstein M, Li PS, Lee RK. Testicular Torsion and Spermatogenesis. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1288:287-306. [PMID: 34453742 DOI: 10.1007/978-3-030-77779-1_14] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Testicular torsion (TT) is a common urologic emergency that can occur at any age. It is most common in newborns and during puberty. Prompt evaluation and management is required to salvage the testis following an episode of torsion. TT brings about damage to testicular tissue and spermatogenesis through various hypothesized mechanisms; however there is a consensus that the effects of ischemia, ischemia-reperfusion injury, and oxidative stress account for the most destructive effects. Numerous studies have examined the effects of various agents and therapies in limiting the effects of TT on the testis.
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Affiliation(s)
- Omar Al Hussein Alawamlh
- James Buchanan Brady Foundation, Department of Urology, Weill Cornell Medical College of Cornell University, New York, NY, USA
| | - Ryan Flannigan
- James Buchanan Brady Foundation, Department of Urology, Weill Cornell Medical College of Cornell University, New York, NY, USA
| | - Russell Hayden
- James Buchanan Brady Foundation, Department of Urology, Weill Cornell Medical College of Cornell University, New York, NY, USA
| | - Marc Goldstein
- James Buchanan Brady Foundation, Department of Urology, Weill Cornell Medical College of Cornell University, New York, NY, USA
| | - Philip S Li
- James Buchanan Brady Foundation, Department of Urology, Weill Cornell Medical College of Cornell University, New York, NY, USA
| | - Richard K Lee
- James Buchanan Brady Foundation, Department of Urology, Weill Cornell Medical College of Cornell University, New York, NY, USA.
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Abbaszadeh A, Assadollahi V, Alasvand M, Anbari K, Tavakoli N, Gholami M. Protective effects of royal jelly on testicular torsion induced ischaemia reperfusion injury in rats. Andrologia 2020; 52:e13716. [DOI: 10.1111/and.13716] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/21/2020] [Accepted: 05/23/2020] [Indexed: 12/11/2022] Open
Affiliation(s)
- Abolfazl Abbaszadeh
- Department of Surgery Razi Herbal Medicines Research Center Lorestan University of Medical Sciences Khorramabad Iran
| | - Vahideh Assadollahi
- Cancer and Immunology Research Center Research Institute for Health Development Kurdistan University of Medical Sciences Sanandaj Iran
| | - Masoud Alasvand
- Cancer and Immunology Research Center Research Institute for Health Development Kurdistan University of Medical Sciences Sanandaj Iran
| | - Khatereh Anbari
- Department of Social Medicine Lorestan University of Medical Sciences Khorramabad Iran
| | - Negin Tavakoli
- Student Research Committee Lorestan University of Medical Sciences Khorramabad Iran
| | - Mohammadreza Gholami
- Medical Biology Research Center Kermanshah University of Medical Sciences Kermanshah Iran
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Investigating the sperm parameters, oxidative stress and histopathological effects of salvia miltiorrhiza hydroalcoholic extract in the prevention of testicular ischemia reperfusion damage in rats. Theriogenology 2020; 144:98-106. [DOI: 10.1016/j.theriogenology.2020.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/22/2019] [Accepted: 01/01/2020] [Indexed: 12/19/2022]
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Bozkurt M, Degirmentepe RB, Polat EC, Yildirim F, Sonmez K, Cekmen M, Eraldemir C, Otunctemur A. Protective effect of hydrogen sulfide on experimental testicular ischemia reperfusion in rats. J Pediatr Urol 2020; 16:40.e1-40.e8. [PMID: 31786227 DOI: 10.1016/j.jpurol.2019.10.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/05/2019] [Indexed: 01/12/2023]
Abstract
AIM Testicular torsion is an urgent urological condition. Ischemia-reperfusion (I/R) processes that occur after detorsion as a treatment for torsion are caused by testicular injury. The purpose of our study is investigating the protecting effect of hydrogen sulfide (H2S) on the testicular ischemia reperfusion injury. MATERIALS AND METHODS Thirty-eight Wistar-Albino rats were divided randomly into 6 different groups: Control (6); sham (6); IR-E (6)-2 h of torsion and 4 h of reperfusion; IR-E + H2S (6)-in addition to the IR-E group, 75 μmol/kg of sodium hydrogen sulfide (NaHS) was administered intraperitoneally 30 min before reperfusion; IR-L (7)-2 h of torsion and 24 h of reperfusion; IR-L + H2S (7)-in addition to the IR-L group, 75 μmol/kg NaHS was administered intraperitoneally 30 min before reperfusion. Biochemically, nitric oxide (NO), malondialdehyde (MDA), superoxide dismutase (SOD), reductive glutathione (GSH), and tumor TNF-α levels were measured in the testis. Serum TNF-α levels were also measured. Hematoxylin and eosin (H & E) was used for histopathological staining and microscopic findings were examined. The Johnsen score was performed to assess spermatogenesis activity in the testis. Apoptosis protease activating factor-1 (Apaf-1) and inducible nitric oxide synthase (iNOS) activity were evaluated immunohistochemically as well. Statistical analyses were made by the Chi-squared test and one-way analysis of variance. RESULTS MDA and NO levels were significantly increased in the IR-L group compared with sham and which decreased by the addition of H2S treatment to the IR-L group (p < 0.05) in biochemical evaluation. GSH vs SOD levels were decreased in the IR-L group compared with sham and which increased by the addition of H2S treatment to the IR-L group, but this correlations were not statistically significant (p > 0.05). Tissue and serum TNF-α levels were significantly increased in the IR-E group compared with sham and which decreased by the addition of H2S treatment to the IR-E group. Johnsen score was the lowest in IR-L group (p < 0.05). Apaf-1 and iNOS activity were significantly increased in the IR-L group compared with sham and which decreased by the addition of H2S treatment to the IR-L group (p < 0.05) in immunohistochemical evaluation. CONCLUSIONS First, the authors would like to say that H2S treatment is protective and it is against ischemia reperfusion injury in testicular torsion. The anti-inflammatory, antioxidant, and antiapoptotic properties of H2S caused protective effect as shown in this study.
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Affiliation(s)
- M Bozkurt
- Mus State Hospital, Department of Urology, Mus, Turkey.
| | - R B Degirmentepe
- University of Health Sciences, Okmeydani Training and Research Hospital, Department of Urology, Istanbul, Turkey
| | - E C Polat
- University of Health Sciences, Okmeydani Training and Research Hospital, Department of Urology, Istanbul, Turkey
| | - F Yildirim
- Istanbul University- Cerrahpasa, Faculty of Veterinary Medicine, Department of Pathology, Istanbul, Turkey
| | - K Sonmez
- Istanbul University- Cerrahpasa, Faculty of Veterinary Medicine, Department of Pathology, Istanbul, Turkey
| | - M Cekmen
- Istanbul Medeniyet University, Department of Biochemistry, Istanbul, Turkey
| | - C Eraldemir
- Kocaeli University, Faculty of Medicine, Department of Biochemistry, Kocaeli, Turkey
| | - A Otunctemur
- University of Health Sciences, Okmeydani Training and Research Hospital, Department of Urology, Istanbul, Turkey
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Kopalli SR, Cha KM, Hwang SY, Jeong MS, Kim SK. Korean Red Ginseng ( Panax ginseng Meyer) with enriched Rg3 ameliorates chronic intermittent heat stress-induced testicular damage in rats via multifunctional approach. J Ginseng Res 2019; 43:135-142. [PMID: 30662302 PMCID: PMC6323164 DOI: 10.1016/j.jgr.2018.06.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 06/01/2018] [Accepted: 06/15/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Panax ginseng Meyer, known as Korean Red Ginseng (KRG), is one of the important age-old traditional herbs used in boosting libido and improving male fertility. In this study, the effects of Rg3-enriched KRG extract (KGC04P) on heat stress-induced testicular damage in experimental rats was evaluated. METHODS Male rats (Sprague-Dawley) were divided into four groups (n = 10): normal control (NC), heat-stressed control (HC), heat-stressed plus KGC04P-100 mg/kg (HK100), and heat-stressed plus KGC04P-200 mg/kg (HK200) groups. Starting 1 week prior to heat stress, animals were administered orally with KGC04P (100 and 200 mg/kg) mixed with a regular pellet diet and continued for 25 weeks. Heat stress was induced to HC, HK100, and HK200 groups by intermittently exposing the animals to high temperatures (32 ± 1°C, 2 h/day). After 6 months, animals were euthanized under general anesthesia with carbon dioxide and evaluated for various parameters in serum and testicular tissue by using Western blotting, biochemical kits, and reverse transcription-polymerase chain reaction. RESULTS Significant (p < 0.05) alterations in several parameters, such as body/organ weight, sperm kinematics, and lipid metabolism marker levels, in the serum and testis of rats were observed. Further, the expression of testicular antioxidant enzymes, inflammatory cytokines, sex hormonal receptors, and spermatogenesis-related genes were also affected significantly (p < 0.05) in the heat-stressed group. However, KGC04P prevented the heat stress-induced changes in rats significantly (p < 0.05) at both concentrations. CONCLUSION KGC04P attenuated heat stress-induced testicular damage by a multifunctional approach and can be developed as an excellent therapeutic agent for hyperthermia-mediated male infertility.
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Affiliation(s)
| | - Kyu-Min Cha
- Department of Biomedical Chemistry, College of Biomedical & Health Science, Konkuk University, Chungju, Republic of Korea
| | - Seock-Yeon Hwang
- Department of Biomedical Laboratory Science, College of Applied Science and Industry, Daejeon University, Daejeon, Republic of Korea
| | - Min-Sik Jeong
- Department of Biomedical Chemistry, College of Biomedical & Health Science, Konkuk University, Chungju, Republic of Korea
| | - Si-Kwan Kim
- Department of Biomedical Chemistry, College of Biomedical & Health Science, Konkuk University, Chungju, Republic of Korea
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Jafari O, Babaei H, Kheirandish R, Samimi AS, Zahmatkesh A. Histomorphometric evaluation of mice testicular tissue following short- and long-term effects of lipopolysaccharide-induced endotoxemia. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2018; 21:47-52. [PMID: 29372036 PMCID: PMC5776436 DOI: 10.22038/ijbms.2017.24415.6083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objective(s):: Lipopolysaccharide (LPS)-induced endotoxemia is known to cause male infertility. This study was designed to explore the effects of bacterial LPS on histomorphometric changes of mice testicular tissues. Materials and Methods: In experiment 1, a pilot dose responsive study was performed with mice that were divided into five groups, receiving 36000, 18000, 9000, and 6750 µg/kg body weight (B.W) of LPS or only saline (control). White blood cells (WBC) were observed for 3 days after LPS inoculation. In experiment 2, two groups of mice were treated with 6750 µg/kg B.W of LPS or only saline (control). Five cases from each experimental group were sacrificed at 3, 30, and 60 days after LPS inoculation. Left testes were fixed in Bouin’s solution, and stained for morphometrical assays. Results: Time-course changes of WBC obtained from different doses of LPS-treated mice showed that inoculation of 6750 µg/kg B.W produced a reversible endotoxemia that lasts for 72 hr and so it was used in the second experiment. In experiment 2, during the first 3 days, no significant changes were observed in the evaluated parameters instead of seminiferous tubules diameter. Spermatogenesis, Johnsen’s score, meiotic index, and epithelial height were significantly affected at 30th day. However, complete recovery was only observed for the spermatogenesis at day 60. Interestingly, deleterious effects of LPS on spermatogonia were only seen at 60th day (P<0.05). Conclusion: Endotoxemia induced by LPS has long-term detrimental effects on spermatogonia and later stage germ cells, which are reversible at the next spermatogenic cycle.
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Affiliation(s)
- Oveis Jafari
- Graduate Student of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Homayoon Babaei
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Reza Kheirandish
- Department of Pathobiology, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Amir-Saied Samimi
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Ali Zahmatkesh
- Graduate Student of Veterinary Medicine, Shahid Bahonar University of Kerman, Kerman, Iran
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Moghimian M, Soltani M, Abtahi H, Shokoohi M. Effect of vitamin C on tissue damage and oxidative stress following tunica vaginalis flap coverage after testicular torsion. J Pediatr Surg 2017; 52:1651-1655. [PMID: 28760456 DOI: 10.1016/j.jpedsurg.2017.07.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 07/03/2017] [Accepted: 07/04/2017] [Indexed: 01/14/2023]
Abstract
AIM OF THE STUDY The aim was to investigate the protective effect of vitamin C on tissue damage and oxidative stress following tunica albuginea incision with tunica vaginalis flap coverage for testicular torsion. MATERIALS AND METHODS Adult male Wistar rats were randomly divided into two experimental groups. The first group experienced 5h of testicular torsion followed by treatment with vitamin C alone, with tunica vaginalis flap coverage alone, and with both vitamin C and tunica vaginalis flap coverage along with a control group subjected to a sham procedure. The second group experienced 9h of testicular torsion followed by the same treatment options as described for the 5h group. The oxidative stress and testosterone levels were measured 24h posttreatment. The Johnsen score, diameter of the seminiferous tubules, and thickness of the seminiferous tubule epithelium were recorded 30days following the treatment. RESULTS The Johnsen score, diameter of the seminiferous tubules, and thickness of the seminiferous tubule epithelium significantly increased in the 5h testicular torsion group receiving treatment with vitamin C and tunica vaginalis flap coverage compared with the group receiving tunica vaginalis flap alone. The level of testosterone decreased significantly in all groups except for the 5h testicular torsion group receiving treatment with vitamin C and tunica vaginalis flap coverage. The MDA level also decreased in the group receiving treatment with vitamin C and tunica vaginalis flap coverage compared with the group receiving tunica vaginalis flap coverage alone. CONCLUSIONS The results showed that the histological parameters and testosterone levels improved with the administration of vitamin C before tunica vaginalis flap coverage in the group experiencing 5h of torsion. This may be a result of the antioxidant effect of vitamin C. No advantage was observed for the 9h group, possibly because the dosage of vitamin C was inadequate.
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Affiliation(s)
- Maryam Moghimian
- Department of Basic Sciences, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Islamic Republic of Iran
| | - Malihe Soltani
- Department of Basic Sciences, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Islamic Republic of Iran.
| | - Hossein Abtahi
- Department of Basic Sciences, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Islamic Republic of Iran
| | - Majid Shokoohi
- Department of Basic Sciences, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Islamic Republic of Iran
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Vaos G, Zavras N. Antioxidants in experimental ischemia-reperfusion injury of the testis: Where are we heading towards? World J Methodol 2017; 7:37-45. [PMID: 28706858 PMCID: PMC5489422 DOI: 10.5662/wjm.v7.i2.37] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 04/07/2017] [Accepted: 05/15/2017] [Indexed: 02/06/2023] Open
Abstract
Testicular torsion (TT) is a medical emergency that primary affects newborns and young adolescents. It causes testicular injury due to the torsion of the spermatic cord and its components, initially in the venous blood flow and finally in the arterial blood flow. Prompt diagnosis and early surgical management are necessary in managing this urgent situation. The process of the pathophysiological events in ischemia-reperfusion is multifactorial and deals with the perception of the oxidative stress responsible for the consequences of ischemia/reperfusion (I/R) stress following TT. Duration and severity of torsion also play a significant role in the oxidative stress. A detrimental result of the defense system of the testes takes place resulting finally in testicular atrophy and impaired function. Antioxidant factors have been experimentally studied in an effort to front this state. They have been classified as endogenous or exogenous antioxidants. Endogenous antioxidants comprise a structure of enzymic enzymatic and non-enzymic enzymatic particles presented within cytoplasm and numerous other subunits in the cells. Exogenous antioxidants include a variety of natural and pharmaceutical agents that may prevent or ameliorate the harmful effects of I/R injury. In this study we review those factors and their ability to enhance the oxidative status of the testis. A feature insight into where we are heading is attempted.
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Ginkgo Biloba Ameliorates Subfertility Induced by Testicular Ischemia/Reperfusion Injury in Adult Wistar Rats: A Possible New Mitochondrial Mechanism. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:6959274. [PMID: 28101298 PMCID: PMC5215564 DOI: 10.1155/2016/6959274] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 10/19/2016] [Indexed: 12/19/2022]
Abstract
Testicular torsion, a surgical emergency, could affect the endocrine and exocrine testicular functions. This study demonstrates histopathological and physiological effects of testicular ischemia/perfusion (I/R) injury and the possible protective effects of Ginkgo biloba treatment. Fifty adult male Wistar rats, 180–200 gm, were randomly divided into sham-operated, Gingko biloba supplemented, ischemia only, I/R, and Gingko biloba treated I/R groups. Overnight fasted rats were anaesthetized by Pentobarbital; I/R was performed by left testis 720° rotation in I/R and treated I/R groups. Orchiectomy was performed for histopathological studies and detection of mitochondrial NAD+. Determination of free testosterone, FSH, TNF-α, and IL1-β in plasma was performed. Plasma-free testosterone was significantly decreased, while plasma FSH, TNF-α, IL-1β, and testicular mitochondrial NAD+ were significantly increased in I/R group compared to control group. These parameters were reversed in Gingko biloba treated I/R group compared to I/R group. I/R caused marked testicular damage and increased APAF-1 in the apoptotic cells which were reversed by Ginkgo biloba treatment. It could be concluded that I/R caused subfertility induced by apoptosis and oxidative stress manifested by the elevated testicular mitochondrial NAD+, which is considered a new possible mechanism. Also, testicular injury could be reduced by Gingko biloba administration alone.
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18
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Shimizu S, Tsounapi P, Dimitriadis F, Higashi Y, Shimizu T, Saito M. Testicular torsion-detorsion and potential therapeutic treatments: A possible role for ischemic postconditioning. Int J Urol 2016; 23:454-63. [PMID: 27217335 DOI: 10.1111/iju.13110] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 03/29/2016] [Indexed: 01/30/2023]
Affiliation(s)
- Shogo Shimizu
- Department of Pharmacology; Kochi Medical School; Kochi University; Nankoku Kochi Japan
| | - Panagiota Tsounapi
- Division of Urology; Tottori University School of Medicine; Yonago Tottori Japan
| | - Fotios Dimitriadis
- Department of Urology; School of Medicine; Ioannina University; Ioannina Greece
| | - Youichirou Higashi
- Department of Pharmacology; Kochi Medical School; Kochi University; Nankoku Kochi Japan
| | - Takahiro Shimizu
- Department of Pharmacology; Kochi Medical School; Kochi University; Nankoku Kochi Japan
| | - Motoaki Saito
- Department of Pharmacology; Kochi Medical School; Kochi University; Nankoku Kochi Japan
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Parlaktas BS, Atilgan D, Gencten Y, Akbas A, Markoc F, Erdemir F, Ozyurt H, Uluocak N. The effects of carvedilol on ischemia-reperfusion injury in the rat testis. Int Braz J Urol 2014; 40:109-17. [PMID: 24642157 DOI: 10.1590/s1677-5538.ibju.2014.01.16] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 09/04/2013] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To analyze the oxidative damage and histopathological alterations caused by ischemia-reperfusion (I/R) injury and ameliorative effects of carvedilol (CVD) in the rat testis. MATERIALS AND METHODS Twenty-one male rats were randomized into 3 groups as follows: Group I (n = 7); control (sham) group, Group II (n = 7); I/R group, in which I/R injury was performed by torsing the left testis 720 ° clockwise for 2 hours and detorsing for 2 hours. Group III (n = 7); CVD treatment group; in addition to I/R process, one-dose of CVD was administered (2mg/kg, i.p) 30 min. before detorsion. Levels of antioxidant enzymes, superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) and levels of malondialdehyde (MDA) and protein carbonyl (PC) were determined in testicular tissues and serum of rats. Testicular tissues were also examined histopathologically and Johnsen scores were determined. RESULTS Activities of SOD and GSH-Px in serum and testicular tissues were increased by I/R, but administration of CVD decreased these levels (p < 0.001 and p = 0.001). Significantly increased MDA levels in serum and testicular tissues were decreased by CVD treatment (p < 0.001 and p = 0.001). Concerning PC levels in serum and testicular tissues, there was no statistically significant difference between the groups (p = 0.989 and p = 0.428). There was not a statistically significant difference in terms of mean Johnsen scores between the groups (p = 0.161). CONCLUSIONS Administration of CVD decreased oxidative damage biochemically in the rat testis caused by I/R injury, but histopathologically no change was observed betwe¬en all of the groups.
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Affiliation(s)
- B S Parlaktas
- Department of Urology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - D Atilgan
- Department of Urology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Y Gencten
- Department of Urology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - A Akbas
- Department of Biochemistry, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - F Markoc
- Department of Pathology (FM), Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - F Erdemir
- Department of Urology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - H Ozyurt
- Department of Biochemistry, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - N Uluocak
- Department of Urology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
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Abstract
Testicular torsion is a urological emergency most commonly seen in adolescence, involving a decrease in blood flow in the testis resulting from torsion of the spermatic cord that can result in gonad injury or even loss if not treated in time. Testicular ischaemia-reperfusion injury represents the principle pathophysiology of testicular torsion, with ischaemia caused by twisting of the spermatic cord, and reperfusion on its subsequent release. Many cellular and molecular mechanisms are involved in ischaemia-reperfusion injury following testicular torsion. Studies have investigated the use of pharmacological agents as supportive therapy to surgical repair in order to prevent the adverse effects of testicular torsion. Numerous substances have been proposed as important in the prevention of post-ischaemia-reperfusion testicular injury. A range of chemicals and drugs has been successfully tested in animal models for the purpose of mitigating the dangerous effects of ischaemia-reperfusion in testis torsion.
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