Akademik Veri Yönetim Sistemi
Turk Uroloji Dergisi, cilt.30, sa.3, ss.273-278, 2004 (Scopus)
Introduction: Subfertilite rates remain high even though testis preserving management had been applied in patients with testicular torsion. The improvement ensured by Hyperbaric Oxygen (HBO) therapy on the injured tissue caused by ischemiac-reperfusion mechanism was shown in several different studies. On account of testicular tortion is an ischemia-reperfusion injury model we searched whether Hyperbaric Oxygen as an additional therapy will have a positive impact on testicular hystology in experimental testicular tortion. Materials and Methods: Spraque Dowley rats were divided into 5 groups, including 10 rats each. The right testes of rats were twisted 720 degree manually in a clockwise rotation after opening the scrotum and releasing the spermatic cord. Rats underwent a second surgical operation to provide the reperfusion; under general anesthesia the testes were detorsed manually and placed into their original place after reopening the scrotum. A 4 hour period of ischemia was applied in the ischemia group. In ischemia+reperfusion group a 24 hour period of reperfusion was applied after releasing the ischemia. In another group the rats were also underwent reperfusion after an ischemiac phase, but the duration of reperfusion was decided to be prolonged to 1 week instead of a 24 hour period. In HBO group following the ischemiac period, rats were anesthetized again and the testes were detorsed manually, thus reperfusion was restarted. Then, rats were taken into rooms used for research studies where pressure was carried out for duration of 1 week. The fifth group is the sham group. Both testes were analyzed hystopathologically after the procedures in all groups. Hystopathological examination was carried out under light microscopy according to the presumable morphological changes visible in the germinal epithelium and nucleus of germ cells. Results: In ischemia group a vesicular nuclear shape of spermatocytes was found. In ischemia+reperfusion group germinal epithelium disorganization and giant cells formed from degenerated sperms and spermatocytes were found as additional findings. In the group where reperfusion was prolonged to one week after a 4 hour period of ischemia, no different hystopathological finding was noted compared to the ischmeia+reperfusion group in which reperfusion was applied only for a 24 hour duration. In the HBO group vesicular nuclear shape of spermatocytes were also found but giant cells were seen rarely. Significant findings due to reperfusion injury were rarely recorded in this group. Conclusion: HBO treatment is an efficient additional therapy model after testicular preserving management in preventing testicular tissue damage in experimental testiculer tortion. Additional studies are needed to put this alternative treatment into clinical practice.