The purpose of this study was to evaluate the variance of apoptosis in rats in which experimental varicocele was induced and then treated by varicocelectomy. Forty adult male Wistar albino rats were used in this experimental study. Experimental varicocele was created in 30 rats. A total of 5 rats underwent a sham operation, and the remaining 5 rats were the control group. A total of 5 rats from the varicocele group were sacrificed on the 14th postoperative day, and 5 more were sacrificed on the 28th postoperative day to document the level of apoptosis due to varicocele. Varicocelectomy was performed on 20 rats with varicocele on the 14th postoperative day. These 20 rats were divided into 4 groups to evaluate the level of apoptosis in their testis after varicocelectomy. They were sacrificed on days 7, 14, 21, and 28 after varicocelectomy. The testes were fixated by perfusion with 10% formaldehyde and then placed in paraffin blocks. From each testis, 2 samples were stained with hematoxylin and eosin, and 2 samples were stained using the TUNEL method. In each specimen, apoptotic germ cells stained by TUNEL were counted in the cross section of 100 seminiferous tubules. The apoptotic index was defined by calculating the number of apoptotic cells per seminiferous tubule. Apoptotic index 5 total apoptotic germ cell count / 100. In the adult rats on which experimental varicocele was performed, both in the second and fourth week, apoptosis in both left and right testes were significantly higher compared with the control group (with varicocele day 14: 0.25-0.26, with varicocele day 28: 0.28-0.32, control: 0.11-0.13). After varicocelectomy on the 7th and 14th days, the slight increase in the level of apoptosis continued (day 7 left testis: 0.30, day 7 right testis: 0.28; day 14 left testis: 0.25, day 14 right testis: 0.31). After varicocelectomy, apoptosis decreased significantly on day 21 (left testis: 0.16, right testis: 0,22), and on day 28 it was almost equal to the level of the control group (left testis: 0.14, right testis: 0.16). After the creation of unilateral varicocele, the level of apoptosis increased in both the left and right testes. Apoptosis in both testes decreased after surgical treatment.
ÖZETÇoğul testis çok nadir görülen bir konjenital anomalidir. Yirmi yaşında sağ inguinal ağrı ile başvuran erkek hastada 3.testis varlığını tespit ettik ve bulgularımızı literatür eşliğinde tartışmayı amaçladık. Fizik muayenede sağ skrotumda sağ testisin üzerinde penis gövdesine yakın 2 cm'lik kitle palpe ettik. Ultrasonografi (USG) ve manyetik rezonans incelemesi (MRI) sonrası bunun üçüncü bir testis olduğunu tespit ettik. Testosteron, folikuler stimulan hormon (FSH), luteal hormon (LH), beta human chorionic gonadotropin (BHCG), alfa fetoprotein (AFP) seviyeleri normal bulundu. Spermiogramda anormallik görülmedi. Bulgular neticesinde üçüncü testis tanısı konularak hasta takibe alındı.Skrotal yerleşimli çoğul testislerde, tümör markerleri normalse ultrasonografi ve manyetik rezonans incelemesi yeterlidir. Cerrahi müdahale ya da biyopsi gerekmez. Konservatif kalınabilir. Ektopik yerleşimli testisler malignite riski nedeniyle cerrahi olarak çıkartılmalıdır. (JAREM 2014; 2: 77-8) Anahtar Sözcükler: Çoğul testis, üçüncü testis, fazlalık testis ABSTRACTPolyorchidism is a very rare congenital disorder. We report triorchidism in a 20-year-old man who presented with pain in the right inguinal region. We palpated a mass near the penile corpus and superior of the right testis. Ultrasonography (USG) revealed a mass near the root of the penis in the right scrotum measuring 22*18*31 mm. Scrotal magnetic resonance imagination (MRI) showed normal left and right testes and a isoinstance third testis between both of them. Testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), beta human chorionic gonadotropin (BHCG), and alpha fetoprotein (AFP) were within the reference range. Semen analysis showed no abnormality. The findings were compatible with the diagnosis of testicular duplication. The patient was followed up conservatively.If the testis is located in the scrotum and testicular tumor markers are negative, surgical exploration or biopsy is not necessary. USG and MRI also help distinguish between testicular and extratesticular pathologic processes and determine the solid and cystic lesion. Following up conservatively is enough. Location of the supernumerary testis in the abdomen or inguinal region carries the risk of testicular cancer; so, orchiectomy is required. (JAREM 2014; 2: 77-8) Key Words: Polyorchidism, triple testes, supernumerary testes GİRİŞ Poliorşidizm oldukça nadir görülen bir doğumsal anomalidir. Literatürde bildirilen vaka sayısı 140 civarındadır (1). Türkiye'den bugüne kadar bildirilmiş poliorşidizm vakası 10 kadardır. Çoğul testisler ektopik ya da atrofik olmaları halinde malignite riski oluş-tururlar (2). Biz bu yazıda üç testisi bulunan 20 yaşındaki hastamı-zın bulgularını literatür eşliğinde tartışmak istedik. OLGU SUNUMUHastanın yazılı onamı alınmıştır. Yirmi yaşında erkek hasta polikliniğimize sağ kasık bölgesinde ağrı şikayetiyle başvurdu. Daha önce başka bir hastalık veya operasyon öyküsü olmayan hastanın son yıllarda belirginleşen ve hareketle artan sağ kasık ve genital bö...
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