Ischemia, whether from ligation or torsion, causes ultrastructural changes on the contralateral testis.
OBJECTIVE
Unilateral testicular torsion results with a decrease in contralateral testicular blood flow caused by a reflexive sympathetic response. The aim of this study was to investigate whether twisting of the spermatic cord, or testicular ischemia without twisting, activates this reflex mechanism and causes ultrastructural changes in the contralateral side.


METHODS
Thirty adult male albino Wistar rats were randomly allocated into three groups of sham, torsion, and ligation. Right testes were twisted 720 degrees counterclockwise in the torsion group. Right spermatic cords were ligated permanently with a silk suture including the vas deferens in the ligation group. After 24 h of testicular ischemia, contralateral left testes were removed for electron microscopic evaluation.


RESULTS
Contralateral testes showed similar ultrastructural changes in the torsion and ligation groups. The fibrous tunica propria enveloping the seminiferous tubule was thickened due to increased collagen fibers. The basal lamina was continuous but thickened and showed several foldings. The gap between basal lamina and the germ cells was increased because of collagen fibers. Leydig cells showed mitochondrial degeneration with the loss of its cristae. Leydig cells lost their contact with its neighborhood cells in some areas, and these gaps were filled with collagen fibers. Germ cells showed dilated cisternae of smooth endoplasmic reticulum, cytoplasmic electron-dense bodies and clear regions.


CONCLUSIONS
Similar electron microscopic findings observed in the torsion and ligation groups indicate that testicular ischemia rather than twisting of the spermatic cord is responsible for the ultrastructural changes in the contralateral side.
Department of Pediatric Surgery, Suleyman Demirel University Medical School, Isparta, Turkey. cagrisavas@e-kolay.net
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Savas
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Ozogul
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Karaoz
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Bezir
D000818:Animals; D004195:Disease Models, Animal; D007150:Immunohistochemistry; D007511:Ischemia / Q000473:pathology*; D008297:Male; D008854:Microscopy, Electron; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D012016:Reference Values; D013086:Spermatic Cord Torsion / Q000473:pathology*; D013737:Testis / Q000098:blood supply* / Q000473:pathology / Q000648:ultrastructure*