Decompressive fasciotomy in testicular torsion of the spermatic cord in rats

Abstract

PURPOSE:To evaluate the effect of decompression fasciotomy on testes undergoing torsion of the spermatic cord. METHODS:Spermatic cord torsion was induced in 40 Wistar testes for six and 12 hours. At the time of distortion, decompression fasciotomy was performed on half of the animals. After 42 days, the testicles were examined both macroscopically and microscopically.A non-parametric Mann-Whitney U-test was used for statistical analysis. The results were considered significant at p≤0.05. RESULTS:Testicular weight; volume and degree of histological alterations were evaluated. When the groups without and with fasciotomy were compared, a 12-hour torsion subgroup in the fasciotomy group was noted to present larger volume, heavier weight and superior histological classification when compared with the 12-hour subgroup in the without fasciotomy group. No differences between the two groups after six hours of torsion were found. No significant changes were noticed in the contralateral testis. CONCLUSIONS:Testicular fasciotomy (decompression) benefited the macroscopic and histological aspects of the testicles undergoing cord torsion for a 12-hour period. These results demonstrate the role played by compartment syndrome in the pathophysiology of spermatic cord torsion and the need for decompression.

Morphological and microcirculatory evaluation of the rat testis after detorsion with or without a capsular release with a tunica vaginalis flap

“…The effect of the tunica albuginea decompression method was primarily investigated by measuring of changes in intra-testicular pressure, testicular volume and weight and as well as with histological examination. In summary, these studies endeavored positive effect on survivability of the testis; 3 8 9 however, the results were not clearly supportive. Besides controversial results in animal models, the clinical experiences can be regarded as promising.…”

“…Quintaes et al . 9 reported larger testicular volume after 12 h torsion in DC testes compared to the DA testes. In contrast, our observations demonstrated signs of testicular atrophy on the 8 th postoperative day in both DC and DA testes presented by decreased testicular volume with even more intensive atrophy of DC testes.…”

“…In a recent study, Quintaes et al . 9 investigated the affectivity of the DC method after 6 and 12 h of torsion in a rat model with the determination of testicular weight and volume, and histological changes. They found that there was no significant difference in the observed parameters between the DA and DC groups after 6 h of torsion while in the group, where 12 h of torsion was induced and the testis underwent capsulotomy, the volume and the weight of the DC testis were larger, and favorable histological alterations were observed.…”

“…Recent experimental studies highlighted the possible effects of increased intra-testicular pressure and effect of capsulotomy after testicular torsion to subsequent spermatogenesis and degree of histological alterations, but the results, which can determine the usefulness of the new approach are remained disputable. 7 8 9 Nonetheless of the favorable initiative clinical results, Oktar et al . 8 did not find correlation between decreased intra-testicular pressure, histopathological and functional changes in a tunica albuginea decompression model in rat.…”

Epididymo-orchitis causing testicular infarction: a serious complication of a common disorder

“…If the tunica vaginalis is considered as a tough unyielding layer, then a compartment syndrome like picture may well occur and surgical decompression may offer a chance at testicular salvage. Animal studies in rats have shown a statistically significant increase in testicular size and volume using this technique in torted rodent testicles compared with a control group [ 10 ]. Other authors have decompressed the epididymis and the spermatic cord in isolated cases with varying successes [ 7 ].…”