Ratlarda gecikmiş testis torsiyon modelinde subkapsüler orşiyektomi sonrası protez olarak bone-wax implantasyonunun sonuçları

Abstract

OBJECTIVE: Classical orchiectomy, which is the only treatment option for delayed testicular torsion, causes serious psychosocial problems in men. Standard testicular prostheses to be implanted to minimize the impact of psychological trauma have high treatment costs. Because standard testicular prostheses cannot be stocked in the operating room, it is impossible to implant it during orchiectomy. Hence, these implants are placed with additional intervention. In this experimental rat model, during subcapsular orchiectomy, we investigated the results of implantation of ovoid-shaped bone-wax paraffin as a testicular prosthesis which could easily be reached almost every operating room. MATERIAL and METHODS: Mature male rats were randomized to two groups, each containing 15 animals. Three hundred and sixty-degree experimental right testicular torsion was applied in Group 1 rats and subsequently randomized to 1A, 1B and 1C subgroups according to their surgical detorsion time 12, 24 and 48 hours later, respectively. Similarly, 720-degree experimental right testicular torsion was applied in Group 2 rats and subsequently randomized to 2A, 2B and 2C subgroups according to their surgical detorsion time 12, 24 and 48 hours later, respectively. Necrotic testicular parenchyma was removed using the subcapsular orchiectomy technique in the groups, ovoid-shaped bone-wax was placed in the tunica albuginea. Thirty days later, bilateral orchiectomy was done all the rats and, specimens were physically and histopathologically examined. RESULTS: Regardless of the duration and degree of torsion, light microscopic examination showed minimal thickening, histiocytic reaction and rare foreign body granulation reaction in the tunica albuginea. Although parenchymal necrosis was detected, tunica albuginea was minimally affected with no serious foreign-body reaction. Bone-wax material mimicked the testis as a testicular prosthesis. CONCLUSION: This experimental study showed that, as an alternative to classical orchiectomy, the results of bone-wax paraffin implantation as a testicular prosthesis after subcapsular orchiectomy were found encouraging in delayed testicular torsion model.