Evaluation of cold ischemia for preservation of testicular function during partial orchiectomy in the rat model

Abstract

Objective We hypothesized that cold ischemia during partial orchiectomy would lead to higher serum testosterone levels and preservation of testicular architecture than warm ischemia in a prepubescent rat model. Materials and methods Eighteen prepubescent male Sprague–Dawley rats were randomized to three different surgical groups: sham surgery, bilateral partial orchiectomy with 30 min of cord compression with cold ischemia, or bilateral partial orchiectomy with 30 min of cord compression with warm ischemia. Animals were killed at puberty, and serum, sperm, and testicles were collected. Histological tissue injury was graded by standardized methodology. Results Mean serum testosterone levels were 1445 ± 590 pg/mL for the sham group, 449 ± 268 pg/mL for the cold ischemia group and 879 ± 631 pg/mL for the warm ischemia group (p = 0.12). Mean sperm counts were 2.1 × 107 for sham, 4.4 × 106 for cold ischemia, and 9.9 × 106 for the warm ischemia groups (p = 0.48). Histological evaluation revealed significant difference in tissue injury grading with more injury in the cold ischemia than in the warm ischemia group (p = 0.01). Conclusions In our preclinical rat model, we found no benefit for cold ischemia over warm ischemia at 30 min.

The role of testis-sparing surgery in children and adolescents with testicular tumors

“…Similarly, Heidenreich et al [30] have recommended immersion of the testis in an ice slush solution after occlusion of the cord, to maintain a temperature of 151C to 191C for the duration of the procedure. Ealier studies in rats have shown that warm ischemia for less than 30 minutes does not result in irreversible injury to Sertoli cells, and cold ischemia provides no benefit at 30 minutes [58,59]. In an effort to minimize warm ischemia time, some authors have described delaying clamping of the cord until after tumor localization [12].…”