Testicular Dysplasia Causing Disturbance of Spermiogenesis in Patients with Unilateral Torsion of the Testis

Abstract

Fifty-five patients were followed up for their state of fertility at a time varying in length after testicular torsion. In addition to the spermiogram they were screened for sperm antibodies. Biopsy samples were collected from the contralateral (not contorted) testis in 34 patients at the time of torsion or immediately afterwards. Two to 8 years after torsion only 7 out of 55 patients had a normal spermiogram. Nineteen had an OAT syndrome, 10 had asthenospermia and 19 had teratospermia. Sperm antibodies occurred very rarely at the time of torsion (2/36) or at the time of a further checkup (2/36). Immunological damage to the noncontorted testis by the contorted one seems therefore rather unlikely. Histology of the contralateral testis, the samples of which were taken at the time of torsion (30) or up to 4 months later (4), showed pathological conditions in 30/34 cases (desquamation of the germinative epithelium, atrophy of the Leydig cells, malformation of spermatoblasts) and normal spermiogenesis in 4 cases only. Hence, a preexistent congenital testicular dysplasia must be assumed to be the cause of the observed disturbance of spermiogenesis and reduced fertility.

DNA Flow Cytometry Reveals Depressed Spermatogenetic Activity in the Contralateral Testis within 24 h of Ipsilateral Spermatic Cord Torsion Independently of the Presence of the Testis and Epididymis

“…Pathologies deteriorating the ipsilateral testis such as torsion [1, 2]nondescent [3, 4], varicocele [5], incarcerated inguinal hernia [6, 7, 8]and vas deferens obstruction [9]may also cause adverse effects on the contralateral testis.…”

“…Preexisting congenital defects [1, 2], incidental occurrence of other conditions such as varicocele [9]and autoimmunity [10]have been the most commonly incriminated mechanisms to explain the contralateral testicular damage.…”

Hemodynamic Monitoring of the Contralateral Testis during Unilateral Testicular Torsion Describes the Mechanism of Damage

“…A preexisting congenital defect, subclinical attacks of contralateral testicular torsion, concurrence of contralateral pathology such as variocele and autoimmunity have all been proposed to account for the contralateral testicular damage [12, 13, 14]. However, none of the proposals is thought to fully explain the mechanism of contralateral testicular injury.…”

Intermittent testicular torsion in 13-year boy

“…Однако в источниках нет сравнительных исследований, демонстрирующих ре-зультаты наблюдений больных с ИПЯ, у которых про-тивоположное яичко не было фиксировано. Данные литературы свидетельствуют о том, что ИПЯ в отда-ленном периоде сопровождается значительными из-менениями репродуктивной функции в виде снижения фертильности до 27 % [9] и ухудшения сперматогене-за у 88 % больных [11]. Поэтому своевременная диаг-ностика, лечение и реабилитация больных с ИПЯ -важные медико-социальные задачи.…”