[Course of tissue acidosis, lactic acid production and morphologic changes in testicular tissue during ischemia. Effect of hypothermic measures].
More than 90% of patients with testicular torsion lose their testis, either because orchiectomy is necessary or because ischaemic atrophy develops. The critical time before irreversible changes to the testis have taken place is, according to literature, 4-6 h. The aim of our study was to measure the tissue acidification (pH) in the testis at different temperatures and to estimate the effect of cooling on pH, lactate accumulation and morphological changes. In 36 human testes (obtained by orchiectomy in patients with metastatic prostate cancer) we measured the tissue acidification (pH), the tissue lactate level and the morphological changes at temperatures of 35, 25, 15 and 5 degrees C. We also measured the same parameters in 12 testes taken from young dogs. At the normal testicular temperature of about 35 degrees C the pH falls to 6.0 within 1 h of ischaemia. Cooling to 15 degrees C can extend this time to 6 h. The tissue lactate level rises from 25 mumol/gdw to nearly 200 mumol/gdw at 35 degrees C. The morphology of semithin sections of the testis shows swelling of the intratubular tissue (spermatogenesis) with loss of the interstitial space. Reducing temperature can also slow-down these changes. The critical pH value of the testis beyond which irreversible changes take place is not known; a pH of less than 6.0 is thought to be the probable threshold.
Kallerhoff
M
M
Urologische Klinik und Poliklinik, Georg August Universität Göttingen.
Coors
A
A
Fischer
C
C
Gröne
H J
HJ
Weidner
W
W
Zöller
G
G
Ringert
R H
RH
D000136:Acid-Base Equilibrium / Q000502:physiology*; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007036:Hypothermia, Induced; D007511:Ischemia / Q000473:pathology / Q000503:physiopathology*; D007773:Lactates / Q000378:metabolism*; D019344:Lactic Acid; D008297:Male; D008875:Middle Aged; D013086:Spermatic Cord Torsion / Q000473:pathology / Q000503:physiopathology; D013737:Testis / Q000098:blood supply* / Q000473:pathology; D014022:Tissue Survival / Q000502:physiology
D007773:Lactates; D019344:Lactic Acid
Verlauf von Gewebeazidose, Milchsäureproduktion und morphologische Veränderungen von Hodengewebe während der Ischämie. Effekt von Kühlungsmassnahmen.