Testicular Torsion: Preliminary Results of In Vitro Cell Stimulation Using Chorionic Gonadotropin

Abstract

Testicular torsion is a pathology that occurs in young males generally before the age of 25. Despite surgery representing the only effective approach, there is still a need to identify a marker that can predict whether a preserved testicle will be functional. In addition, no therapeutic approach is currently considered in the post-operative phase. Through an approach based on the in vitro culture of a tissue strictly linked to the testicle, the gubernaculum, we defined the healthy state of the organ and the possible responsiveness to a therapy used in the andrology field, chorionic gonadotropin (hCG). Firstly, we optimized a protocol to obtain viable cells starting from a small piece of gubernacular tissue harvested during surgery with the aim to amplify cells in vitro. Intriguingly, only for a patient whose testicle had been removed during surgery due to an excessive necrotic area, gubernacular cells were not able to grow in culture. These data support the possibility of exploiting the gubernaculum to evaluate the healthy state of the testicle. Then, as we demonstrate that gubernacular cells express a luteinizing hormone receptor, to which hCG is specific, we analyzed the cellular response to hCG treatment on in vitro cultured cells derived from patients affected by testicular torsion. Our study opens the way for the possibility of evaluating testicle wellbeing after derotation through in vitro culture of a small piece of gubernaculum together with predicting the response to the treatment with hCG, which can have a positive effect on cell proliferation and vascularization.

Quality Assessment of YouTube Videos as an Information Source for Testicular Torsion

“…The torsion of the spermatic cord can reach 180 to more than 720 degrees, resulting in different levels of ischemia and even necrosis in testicular tissue. The viability of testis decreases 6 h after the onset of symptoms [ 3 ]. It has been reported that the orchiectomy rate was 42% in boys undergoing surgery for testicular torsion, and ~56.6% of boys receiving salvage orchiopexy had testicular atrophy [ 4 , 5 ].…”

Mitochondrial Dynamics as Potential Modulators of Hormonal Therapy Effectiveness in Males

“…Nowadays, besides surgical intervention, no therapeutic approaches are indicated during the recovery phase. However, very recently, we reported experimental results about the possibility to use human gonadotropin hormone (hCG), which is commonly prescribed to improve fertility potential in infertile men and to increase testicular trophism in post-operative cryptorchid patients, as adjuvant therapy also for patients with testicular torsion to improve testicle health [ 9 ].…”

“…However, how these therapies impact other andrological pathologies is still being defined. Recently, an in vitro culture study of a tissue closely linked to the testis, i.e., gubernaculum, showed promising data on the adjuvant hCG monotherapy for testicular and spermatic cord torsion for which no therapeutic approach is currently considered in the post-operative phase [ 9 ]. In this study, it has been shown that the in vitro growth of gubernacular cells derived from three different patients with diverse degrees of testis torsion depended on the severity of the damage; indeed, cells derived from a patient whose testicle was removed because too damaged were not able to grow in culture.…”

“…Functionally, the full-length hLHCGR exploits its central role in a physiological aspect of gonadal maturation by binding both hCG and LH mainly on the cell membrane of the ovarian theca, granulosa, luteal, and Leydig cells [ 61 ]. Furthermore, there is evidence that cells that compose the gubernaculum testis may express LHCGR [ 9 ]. To achieve proliferation and differentiation of a variety of cell types, the primary pathways exploited by the activated LHCGR, once it couples with Gα s G-proteins, are signaling pathways of cAMP/PKA, ERK, and protein kinase B (PKB/AKT) [ 56 , 61 ].…”

Testicular torsion in adults: which news?

“…It is therefore essential that research proposes new diagnostic and therapeutic treatments after surgical procedures to ensure better testicular vascularization and vitality of the testis. 4 …”