Testicular Torsion: Direction, Degree, Duration and Disinformation

Sessions, Annette; Rabinowitz, Ronald; Hulbert, William C.; Goldstein, Martin; Mevorach, Robert A.

doi:10.1016/s0022-5347(05)63987-0

Cited by 197 publications

(92 citation statements)

References 18 publications

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“…The severity of testicular damage is generally suggested to be related to the time and degree of TT. Despite the prompt diagnosis and treatment, testicular atrophy and fertility are major problems in the follow up [1,2].…”

Section: Introductionmentioning

confidence: 99%

Dexpanthenol attenuates lipid peroxidation and testicular damage at experimental ischemia and reperfusion injury

et al. 2006

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Prevention of tissue damage after testicular torsion caused by I/R injury is still a clinical and experimental problem. There are many experimental studies made with several chemicals in the literature for decreasing the effect of reactive oxygen species after ischemia and reperfusion. Dexpanthenol (Dxp) is the biologically active alcohol of pantothenic acid. Pantothenic acid increases the content of reduced glutathione, Coenzyme A and ATP in cell. We studied the effect of Dxp on lipid peroxidation and testicular damage. Forty adult rats were separated randomly into five groups: group Sh, Sham-operation; group TD, torsion-detorsion; group NS, torsion-normal saline-detorsion; group D, torsion-Dxp 250 mg/kg detorsion; group D2, torsion-Dxp 500 mg/kg detorsion group. Serum MDA levels were taken before detorsion, after torsion at the first and fifth minute and at the first hour. Tissue sample was taken at the first hour. The alterations of I/R injury on testis were histological graded. Serum MDA levels were significantly lower in group D2 compared to all groups. The histopathology score of group D2 was significantly lower than groups TD, NS and D. Histopathological score and serum MDA levels are strikingly compatible. Dxp attenuated lipid peroxidation and tissue damage at I/R injury. This effect depends on its antioxidant effect with increasingly reduced glutathione, Coenzyme A and ATP. The effect of Dxp on I/R injury has been shown for the first time in the experimental testicular torsion.

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Section: Introductionmentioning

confidence: 99%

Dexpanthenol attenuates lipid peroxidation and testicular damage at experimental ischemia and reperfusion injury

et al. 2006

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“…These strategies include the twisting of the spermatic cord to different degrees (180° to 1080°) and ligation of the spermatic artery (Sessions et al, 2003). However, the most widely used models to evaluate the effect of ischemia/reperfusion on spermatogenesis in the adult rat involve a 720° rotation for 1-6 h and persistent damage after 60 days, which may even be irreversible (Becker and Turner, 1995;Silva et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

“…Surgical treatment of this condition involves the manual detorsion of the testes, restoration of their anatomical position, and orchiopexy (Bolln et al, 2006). Orchiectomy and prophylactic contralateral orchiopexy are indicated in cases of testicular necrosis (Sessions et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Twisting of the spermatic cord: ischemia and reperfusion, toxicogenetic evaluation, and the effects of phosphatidylcholine in pre-clinical trials

Coelho¹,

Berno²,

Falcão

et al. 2016

Genet. Mol. Res.

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ABSTRACT. Phosphatidylcholine is the main phospholipid present in cell membranes and in lipoproteins, and can interfere with various biological processes. This lipid also has antioxidant activity, and protects against damage caused by free radicals under conditions of ischemia/reperfusion. Therefore, the present study was designed to evaluate toxicogenetic damage caused by twisting of the spermatic cord in ischemia/reperfusion, and whether phosphatidylcholine plays a role in conditions of ischemia/reperfusion in preclinical trials. The results indicate that spermatic cord torsion does not cause genotoxic damage or mutagenesis. A dose of 300 mg/kg of phosphatidylcholine is toxic and is thus not recommended. However, a dose of 150 mg/kg does not promote toxicogenetic damage, and though it does not statistically prevent tissue damage occurring from lack of oxygenation and nutrition of testicular cells, it has a tendency to reduce this damage. Therefore, this research suggests that further studies should be conducted to clarify this tendency and to provide a better explanation of the possible therapeutic effects of phosphatidylcholine in cytoprotection of germ cells affected by ischemia/reperfusion.

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“…Therefore, we planned to perform an inward de-torsion contrary to the recommendations from the initial intervention. [2][3][4] Sudden relief of pain occurred and the testicular arterial flow was demonstrated by CDU after the 720 o inward detorsion was completed. In addition, after the manoeuvre, the spermatic cord was in the neutral position.…”

Section: Discussionmentioning

confidence: 99%

“…Although the main approach for manual de-torsion is to de-rotate the testis and the spermatic cord laterally, almost one-third of patients may require medial de-torsion. 4 Therefore, dramatic pain relief and a reduction of the rotation resistance in the course of manual de-torsion should be considered. 2,3 Monitoring the testicular arterial blood flow with CDU following manual de-torsion is also crucial.…”

Section: Introductionmentioning

confidence: 99%

A novel approach for manual de-torsion of an atypical (outward) testicular torsion with bedside Doppler ultrasonography guidance

Güneş

Umul

Çelik

et al. 2015

CUAJ

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A 17-year-old boy presented with right testicular torsion to the lateral side. Torsion was diagnosed by physical examination; the colour Doppler ultrasonography (CDU) confirmed right testicular torsion with minimal peripheral hydrocele. Transverse and longitudinal examination of the spermatic cord with ultrasound and CDU revealed a counter-clockwise testicular torsion. Manual de-torsion was performed in a clockwise direction (720o) and testicular blood flow and the neutral position of the spermatic cord were confirmed by CDU. We did not encounter a residual twist of the spermatic cord upon surgical exploration. In our experience, ultrasound and CDU may predict the direction of testicular torsion and may allow appropriate management of cases prior to surgery.

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Testicular Torsion: Direction, Degree, Duration and Disinformation

Cited by 197 publications

References 18 publications

Dexpanthenol attenuates lipid peroxidation and testicular damage at experimental ischemia and reperfusion injury

Dexpanthenol attenuates lipid peroxidation and testicular damage at experimental ischemia and reperfusion injury

Twisting of the spermatic cord: ischemia and reperfusion, toxicogenetic evaluation, and the effects of phosphatidylcholine in pre-clinical trials

A novel approach for manual de-torsion of an atypical (outward) testicular torsion with bedside Doppler ultrasonography guidance

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