title: Modulation of Thrombosis Significantly Reduces Testicular Damage after Testicular Torsion in Rats: Anti-Thrombotic Treatment and Testicular Torsion.
abstract: OBJECTIVE
  To evaluate the effects of thrombolysis and/or anticoagulation on testicular viability after testicular tortion (TT) was the aim of this study. It has been suggested that alterations of circulation during TT result in thrombus formation that might prevent sufficient perfusion after detorsion. Due to the narrow safety margin of testicular perfusion, even moderate disturbances in blood supply can cause major testicular damage.
  
  
  METHODS
  In 112 rats, the right testicle was torsed for 3 or 6 hours. After detorsion and randomization, they received either enoxaparin, alteplase, both, or placebo, according to their subgroup. Thrombus formation was accessed via D-dimers, pDNA, oxidative testicular damage was evaluated via glutathione peroxidase and malondialdehyde, and cellular damage via inhibin B, testosterone, histological analysis (Johnsen score, Cosetino grading), and TUNEL assay.
  
  
  RESULTS
  One hundred and twelve rats were included in the study. The treatment with alteplase or enoxaparin showed significantly less testicular damage and significantly improved Sertoli cell function. Enoxaparin significantly reduced oxidative impairment.
  
  
  CONCLUSIONS
  The results of the study indicate that TT induces thrombus formation and demonstrate that modulation of thrombosis significantly ameliorates testicular damage in rats. Hence, this treatment option after TT ought to be evaluated in humans.
authors.affiliation: Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: m.boettcher@uke.de.
authors.forename: Michael
authors.initials: M
authors.lastname: Boettcher
authors.affiliation: Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Tobias A
authors.initials: TA
authors.lastname: Fuchs
authors.affiliation: Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Hansjörg
authors.initials: H
authors.lastname: Schäfer
authors.affiliation: Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Appl
authors.affiliation: Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Trochimiuk
authors.affiliation: Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Miguel
authors.initials: M
authors.lastname: Jiménez-Alcázar
authors.affiliation: Department of Experimental Animal Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Bastian
authors.initials: B
authors.lastname: Tiemann
authors.affiliation: Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Roman
authors.initials: R
authors.lastname: Jung
authors.affiliation: Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Bergholz
authors.affiliation: Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Konrad
authors.initials: K
authors.lastname: Reinshagen
authors.affiliation: Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Eschenburg
mesh_terms: D000818:Animals; D000925:Anticoagulants / Q000627:therapeutic use*; D017984:Enoxaparin / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D008297:Male; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D013086:Spermatic Cord Torsion / Q000150:complications / Q000628:therapy*; D013737:Testis / Q000098:blood supply*; D013927:Thrombosis / Q000209:etiology / Q000628:therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator