Histological Effects Of Unilateral Spermatic Cord Torsion Without Removal Of The Ipsilateral Necrotic Testis On The Contralateral Testis In Rats

Background and Objective: Spermatic cord torsion is a commonurologic emergency. Each year, spermatic cord torsion affects one in 4,000males younger than 25 years. Orchiectomy rates ranged from 39% to 71% asshown in most studies. It is controversial whether we should carry outdetorsion to preserve the ipsilateral testis, or perform an orchiectomy topreserve the function of the contralateral testis after spermatic cord torsion oflong duration (> 24 hours). This study was designed to evaluate thehistological effects of unilateral spermatic cord torsion without removal ofthe ipsilateral necrotic testis on the contralateral testis in rats.Materials and Methods: Thirty-three male Sprague–Dawley rats (aged21-42 days) were divided into three groups: the sham-operated group (n=11),torted group (n=12) and orchiectomized group (n=10). In the sham-operatedgroup, dartos pouch orchidopexy was performed on the left testis. In the later2 groups, a 720°unilateral spermatic cord torsion on the left side wasinduced by scrototomy and dartos pouch orchidopexy. 96 hours later aftertorsion, the twisted testis was either untwisted (without removal of the testis) in the torted group, or removed in the orchiectomized group. 3 monthspostoperation, serum samples were obtained from the inferior vena cava andtestosterone and antisperm antibody were measured using the enzyme-linkedimmunosorbent assay method; testes and epididymides were removed, andtesticular and epididymal sections (paraffin-embedded) were obtained forhistology. In addition, the volumes of various structures in the testis orepididymis and the diameter of the seminiferous tubules were obtained usingstereological methods.Result: Testosterone concentrations in the sham-operated, torted andorchiectomized groups were 2.981±0.413, 3.314±0.376 and 2.931±0.272(ng/ml, x±SEM), respectively, without significant differences between thegroups. Anti-sperm antibody was detected positive in only 1 animal in thetorted group.Coagulation necrosis was seen in the twisted testis in the torted group.Marked morphological changes were observed in 1, 3 and 0 animals in thesham-operated, torted and orchiectomized groups, respectively. The changesincluded mainly atrophy of the seminiferous tubules and reduction in thenumbers of spermatogenic cells. The volume of the contralateral testissignificantly (P < 0.05) increased by 19% and 21% in the torted andorchiectomized groups, respectively, in comparison with that in the sham-operated group.The volumes of the seminiferous tubules in the contralateral testis were1.15±0.07, 1.30±0.04 and 1.35±0.05 cm3in the sham-operated, tortedand orchiectomized groups, respectively, without significant differencebetween the groups; The volumes of the interstitial tissue were 0.25±0.02,0.36±0.02 and 0.34±0.03 cm3, respectively, there was a significant differencein the torted or orchiectomized group compared with the sham-operatedgroup (P < 0.05); and the diameters of the tubules were 226±7, 223±6 and221±3μm, respectively, without significant difference between the groups.The Leydig cell nuclei in the contralateral testis appeared larger in thetorted or orchiectomized group compared with the sham-operated group. Thevolumes of the agglomerated sperm mass stored in the contralateralepididymis were without much difference between the groups.Conclusion: Unilateral orchiectomy or testicular necrosis afterspermatic cord torsion resulted in some compensatory hypertrophy of thecontralateral testis; histological effects (on the contralateral testis) ofunilateral spermatic cord torsion followed by orchiectomy were similar to theeffects of the torsion without orchiectomy (i.e. by leaving the ipsilateral testisnecrosed).