title: Late hormonal levels, semen parameters, and presence of antisperm antibodies in patients treated for testicular torsion.
abstract: In spite of prompt diagnosis and either orchiectomy or preservation of the affected testis, infertility remains a significant sequel to testicular torsion. The objective of this study was to evaluate the late endocrine profile, seminal parameters, and antisperm antibody levels after testicular torsion. We also analyzed the impact of orchiectomy or detorsion on the organ fate. Of 24 patients evaluated after testicular torsion, 15 were treated with orchiectomy (group 1) and 9 were treated with orchiopexy (group 2). All subjects were assessed by semen analysis, endocrine profile (levels of follicle-stimulating hormone, luteinizing hormone, and testosterone), and seminal antisperm antibody levels. A group of 20 proven fertile men was used as the control. Median ischemia time in group 1 (48 hours) was significantly higher than in group 2 (7 hours). Both groups demonstrated decreases in sperm count and morphology compared with controls. Group 1 showed a significantly higher motility than group 2 (P = .02). Group 1 also showed a significantly better morphology by World Health Organization and Kruger criteria than group 2 (P = .01). All patients presented endocrine profiles within the normal range, and no significant differences in antisperm antibody levels were detected between the groups. However, a trend for higher levels was found in patients treated for testicular torsion, regardless of the fate of the testis. Moreover, no significant correlation was found between antisperm antibody levels and age at torsion, ischemia time, seminal parameters, or treatment applied. In conclusion, we found that after torsion patients maintain late hormonal levels within the normal range. Testicular fate did not have any correlation with the formation of antisperm antibodies. Although sperm quality was preserved in most of the patients with the exception of sperm morphology, patients treated with orchiectomy presented better motility and morphology compared with the detorsion group. Further studies may clarify whether maintenance of a severely ischemic testicle may impair testicular function.
authors.affiliation: Department of Urology, University of São Paulo, Rua Adma Jafet, 50/3o andar, São Paulo 01308-050, SP, Brazil. marcoarap@usp.br
authors.forename: Marco A
authors.initials: MA
authors.lastname: Arap
authors.forename: Fabio C
authors.initials: FC
authors.lastname: Vicentini
authors.forename: Marcello
authors.initials: M
authors.lastname: Cocuzza
authors.forename: Jorge
authors.initials: J
authors.lastname: Hallak
authors.forename: Kelly
authors.initials: K
authors.lastname: Athayde
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Lucon
authors.forename: Sami
authors.initials: S
authors.lastname: Arap
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
mesh_terms: D000293:Adolescent; D000328:Adult; D001323:Autoantibodies / Q000097:blood*; D005640:Follicle Stimulating Hormone / Q000097:blood; D007839:Functional Laterality; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D009919:Orchiectomy; D012661:Semen / Q000502:physiology*; D013076:Sperm Count; D013081:Sperm Motility; D013086:Spermatic Cord Torsion / Q000097:blood / Q000276:immunology / Q000601:surgery*; D013094:Spermatozoa / Q000276:immunology*; D013737:Testis / Q000601:surgery*; D013739:Testosterone / Q000097:blood
chemical_list: D001323:Autoantibodies; D013739:Testosterone; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone