The Effect of Prepubertal Spermatic Cord Torsion on Subsequent Fertility in Rats

Abstract

This study was undertaken to determine the effects of various durations of testicular torsion in prepubertal rats on their subsequent fertility, and to determine whether these effects could be altered by removal of the torsioned testis. Sixty rats (35 days old) were subjected to 720 degrees unilateral spermatic cord torsion for 0, 1, 3, 5, 9, or 12 hours. The torsioned testis was then either detorsioned or removed. At 65 days of age each male was housed with two females for three weeks. Rats undergoing detorsion of the spermatic cord demonstrated a linear decrease in fertility with respect to the duration of torsion (r = -0.904). However, all of the animals undergoing unilateral torsion with subsequent orchiectomy were fertile, regardless of the duration of torsion. In addition, the percentage of females impregnated, the number of embryos produced, and the mean embryo size decreased with increasing intervals of torsion (r = -0.834 to r = -0.979); the sharpest decline occurred between 5 and 9 hours of torsion. All of these parameters were significantly lower (P less than 0.001 to P less than 0.05) in the detorsioned group as compared to the orchiectomized group. There was a decrease in seminiferous tubule diameter in the contralateral testis with respect to the duration of torsion (P less than 0.01). These data indicate that unilateral spermatic cord torsion in young rats significantly reduced their subsequent fertility with respect to duration of the torsion, and that this detrimental effect may be minimized if the damaged testis is removed rather than untwisted and replaced into the scrotum.

Preventable causes of male infertility

“…The same studies have shown that contralateral testicular dysfunction occurs when the affected testicle is left in situ. Further animal studies have supported the concept that the presence of a torsed testis in situ for prolonged periods has a deleterious effect on the contralateral testis and that early removal of the torsed organ has a protective effect on the opposite testis [19]. Overall, the data are very supportive of an immunologically mediated contralateral effect in postpubertal animals [110].…”

Spermatic cord torsion, reactive oxygen and nitrogen species and ischemia–reperfusion injury

“…Several studies have claimed that the contralateral testis is not affected by unilateral torsion (Turner, 1985;Becker and Turner, 1995;Anderson and Williamson, 1990;Turner and Brown, 1993;Akg€ ur et al, 1993Akg€ ur et al, , 1995 while others favored the opposite view (Nagler and deVere White, 1982;Cerasaro et al, 1984;Cosentino et al, 1984;Thomas et al, 1984;Sade et al, 1988;Tanyel et al, 1989;Saba et al, 1997;Kosar et al, 1997;€ Ozkan et al, 2004). These discrepancies appear to stem, in some cases, from the different animal models used, which fail to produce a reliable testicular ischemia-reperfusion situation (Costabile et al, 1994).…”

“…Some studies in laboratory animals reported no effect of torsion/detorsion (Turner, 1985;Becker and Turner, 1995;Nagler et al, 1984) while others reported several biochemical (Akg€ ur et al, 1993(Akg€ ur et al, , 1994 and histological changes (Nagler and deVere White, 1982;Cerasaro et al, 1984;Cosentino et al, 1984) that were indicative of tissue damage. These conflicting reports have led to two distinct recommendations regarding surgical procedures: detortion and preservation of the ipsilateral testis (Anderson and Williamson, 1990;Anderson et al, 1992), or its orchiectomy to preserve contralateral function and fertility (Cosentino et al, 1984;Sarica et al, 1997). A study carried out in humans indicates that an early (mean torsion time of less than 13 h) surgical intervention with detorsion preserves fertility but prolonged torsion periods (mean torsion time of 70 h) followed by orchieoctomy jeopardize fertility (Anderson et al, 1992).…”

Pyrimethamine: an approach to the development of a male contraceptive.

“…The number of pregnancies occurring in each test group was also noted. The size and number of embryos in those females that did become pregnant were assessed and the product of these two factors was used as an index of fecundity (11)(12)(13).…”