The acute effects of increased intra-abdominal pressure on testicular tissue: an experimental study in pigs.
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.
Istanbulluoglu
Mustafa Okan
MO
Gülhane Military Medical Academy, Department of Urology, Ankara, Turkey.
Piskin
Mesut
M
Zor
Murat
M
Celik
Asuman
A
Ozgok
Aysegul
A
Ates
Mutlu
M
Ustun
Huseyin
H
Ozgok
Yasar
Y
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