title: The acute effects of increased intra-abdominal pressure on testicular tissue: an experimental study in pigs.
abstract: OBJECTIVE
  To evaluate the acute effects of increased intra-abdominal pressure (IAP) on testicular germ cell apoptosis and the expressions of endothelial nitric oxide synthase (eNOS), inducible nitric-oxide synthase (iNOS), and Johnson's scores in testicular tissue.
  
  
  METHODS
  Twelve male pigs weighing 52 to 55 kg were divided into 2 groups as group 1 (n = 6; gasless [control]) and group 2 (n = 6; 20 mm Hg IAP with CO(2) pneumoperitoneum for 4 hours). In the second group, left laparoscopic nephrectomy was performed during the CO(2) insufflation period. The right testes of pigs were removed. Testicular germ cell apoptosis, expressions of eNOS and iNOS, and Johnson's scores were evaluated for each group.
  
  
  RESULTS
  The control group (group 1) exhibited low apoptotic cell level and low iNOS and eNOS level in testes. IAP (group 2) resulted in marked increases in germ cell apoptosis, eNOS, and iNOS compared with the control group (group 1) (P <.05). However, no significant difference was noted in Johnson's scores between the 2 groups (P >.05). Moreover, Leydig cell hyperplasia, congestion, and necrosis, which were not documented in the control group, were seen in the study group.
  
  
  CONCLUSIONS
  The purpose of the present study was to evaluate whether IAP could affect germ cell apoptosis and NOS concentrations in the testes after laparoscopic procedures in an animal model. In such an animal model simulating laparoscopic procedures, we demonstrated that high-pressure and long-lasting CO(2) insufflation cause testicular changes in the acute period.
authors.affiliation: Gülhane Military Medical Academy, Department of Urology, Ankara, Turkey.
authors.forename: Mustafa Okan
authors.initials: MO
authors.lastname: Istanbulluoglu
authors.forename: Mesut
authors.initials: M
authors.lastname: Piskin
authors.forename: Murat
authors.initials: M
authors.lastname: Zor
authors.forename: Asuman
authors.initials: A
authors.lastname: Celik
authors.forename: Aysegul
authors.initials: A
authors.lastname: Ozgok
authors.forename: Mutlu
authors.initials: M
authors.lastname: Ates
authors.forename: Huseyin
authors.initials: H
authors.lastname: Ustun
authors.forename: Yasar
authors.initials: Y
authors.lastname: Ozgok
mesh_terms: D000005:Abdomen; D000818:Animals; D007511:Ischemia / Q000209:etiology* / Q000473:pathology; D010535:Laparoscopy; D008297:Male; D011312:Pressure / Q000009:adverse effects*; D013552:Swine; D013737:Testis / Q000098:blood supply* / Q000473:pathology