title: Primary testicular lesions in the twisted testis.
abstract: OBJECTIVE
  To investigate primary lesions in twisted testes.
  
  
  METHODS
  The histologic study of testicular specimens obtained from men who had suffered testicular torsion.
  
  
  METHODS
  The conditions required for material selection were the knowledge of the exact time of torsion and the presence of recognizable seminiferous epithelium cells.
  
  
  METHODS
  Two hundred eighteen testicular torsions treated in La Paz Hospital, Madrid, Spain, from 1970 to 1990.
  
  
  METHODS
  After rejection of specimens that did not fulfill the conditions for selection, 109 biopsy and orchidectomy specimens from pubertal and adult males were studied to determine if primary lesions are superimposed to lesions secondary to anoxia.
  
  
  RESULTS
  The following primary tubular lesions were found: (1) focal hypospermatogenesis (5 biopsies and 1 orchidectomy specimen; these testes showed degree I, II, or III anoxic lesions); (2) hypoplastic zones with only immature and hyperplastic Sertoli cells (3 orchidectomy specimens with degree III lesions); (3) zones of Sertoli-cell-only tubules that only contained a normal amount of mature appearing Sertoli cells (5 orchidectomy specimens with degree III lesions); and (4) intratubular calcifications (1 orchidectomy specimen with degree III lesions). In two cases with degree III lesions, more than one primary testicular lesion could be observed.
  
  
  CONCLUSIONS
  An important number of twisted testes bear primary lesions that might had been involved in torsion development. The real percentage is probably even higher than that found in this study (14%) because the material obtained (biopsies) in many cases was insufficient to ensure complete exploration and because primary lesions are not recognizable in areas with pronounced anoxic lesions.
authors.affiliation: Department of Morphology, Autonomous University of Madrid, School of Medicine, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Nistal
authors.forename: C
authors.initials: C
authors.lastname: Martínez
authors.forename: R
authors.initials: R
authors.lastname: Paniagua
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D006470:Hemorrhage / Q000209:etiology / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009336:Necrosis; D013086:Spermatic Cord Torsion / Q000150:complications / Q000473:pathology*; D013733:Testicular Diseases / Q000209:etiology / Q000473:pathology; D013737:Testis / Q000473:pathology*