Effect of hyperbaric oxygen therapy on testicular ischemia-reperfusion injury.
OBJECTIVE
Testicular torsion is a urologic emergency representing a form of ischemia-reperfusion (IR) injury that requires prompt care to achieve tissue salvage and a reduction in post-torsion morbidity. Hyperbaric oxygen (HBO) has shown benefits in previous musculoskeletal models of IR. We evaluated the efficacy of HBO treatment in a rat testicular torsion model.


METHODS
Four groups of male Wistar rats were included in this study: 1) Sham (n=16), spermatic cords exposed but not occluded; 2) Control (n=16), 4 hours of bilateral spermatic cord occlusion; 3) HBO during ischemia (n=18), 4 hours of occlusion and administration of HBO during the last 90 minutes of ischemia; and 4) HBO on reperfusion (n=8), HBO administered immediately upon reperfusion of the testes. The animals were sacrificed at two weeks and architecture and germinal epithelial cell thickness were determined by histological examination on each testicle. Average thickness (in cell layers) of each group was compared with control using Student's t test.


RESULTS
Control testicles showed a significant reduction in germinal cell thickness compared with sham (1.7 versus 6.3, p <0.05). The animals treated with HBO during ischemia showed a significant increase in epithelial cell thickness compared with control (2.8 versus 1.7, p <0.05). Hyperbaric oxygen treatment during reperfusion had the greatest beneficial effect compared with control (5.1 versus 1.7, p <0.05).


CONCLUSIONS
Adjunctive HBO therapy administered during ischemia or reperfusion significantly reduced injury to the testicle in this animal model. These results suggest a potential benefit of HBO treatment in clinical situations of testicular torsion.
Division of Plastic Surgery, University of Nevada School of Medicine, Las Vegas 89102, USA.
J M
JM
Kolski
P J
PJ
Mazolewski
L L
LL
Stephenson
J
J
Texter
V E
VE
Grigoriev
W A
WA
Zamboni
D000704:Analysis of Variance; D000818:Animals; D001485:Basement Membrane / Q000473:pathology; D002452:Cell Count; D004195:Disease Models, Animal; D004847:Epithelial Cells / Q000473:pathology; D006931:Hyperbaric Oxygenation; D007511:Ischemia / Q000628:therapy; D008297:Male; D051381:Rats; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000473:pathology / Q000628:therapy*; D012671:Seminiferous Tubules / Q000473:pathology; D013086:Spermatic Cord Torsion / Q000150:complications / Q000628:therapy; D013733:Testicular Diseases / Q000473:pathology / Q000628:therapy*; D013737:Testis / Q000098:blood supply / Q000473:pathology