title: The effectiveness of extra-scrotal fixation following manual detorsion for testicular torsion: a pilot study in a rabbit model.
abstract: BACKGROUND
  To investigate the effectiveness of manual detorsion (MD) and applicability of extra-scrotal fixation for testicular torsion in a rabbit model.
  
  
  METHODS
  Twelve New Zealand male rabbits were randomized into six groups of two rabbits each. A single-side testicular torsion (TT) model (different degrees, time and sides) was performed in all groups except the Sham group. The groups included: Group 1 (180°; 4 h), Group 2 (720°; 6 h), Group 3 (1080°; 9 h), Group 4 (540°; 1 h), Group 5 (900°; 2 h), and Group 6 (sham-only). Testes were examined by another urologist and radiologist with Color Doppler Ultrasonography (CDU). MD was performed with CDU until blood flow was observed in the affected testis. Extra-scrotal fixation was then conducted in these animals. The testes were then harvested for blinded histopathological examinations.
  
  
  RESULTS
  TT was detected in all animals except the control group. The CDU examination detected decreased blood flow only in Group 1. An opposite rate was observed between the spermatic cord diameter and torsion degree. A wrong direction of MD in the first step was observed in two rabbits in Groups 4 and 5. Torsion signs were observed only in Group 3. Rest torsion was observed in Groups 3 and 5 after extra-scrotal fixation. Histopathological examinations showed that testicular damage increased in parallel to torsion duration.
  
  
  CONCLUSIONS
  Extra-scrotal fixation after MD along with CDU may be a simple and minimally invasive treatment option in TT therapy. However, this must be verified with further studies.
authors.affiliation: Süleyman Demirel University, Faculty of Medicine, Department of Urology, Isparta, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Güneş
authors.affiliation: Süleyman Demirel University, Faculty of Medicine, Department of Urology, Isparta, Turkey.
authors.forename: Muammer
authors.initials: M
authors.lastname: Altok
authors.affiliation: Mehmet Akif Ersoy University, Faculty of Veterinary Medicine, Department of Pathology, Burdur, Turkey.
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Özmen
authors.affiliation: Süleyman Demirel University, Faculty of Medicine, Department of Radiology, Isparta, Turkey.
authors.forename: Bumin
authors.initials: B
authors.lastname: Değirmenci
authors.affiliation: Mehmet Akif Ersoy University, Faculty of Veterinary Medicine, Department of Pathology, Burdur, Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Özyildiz
authors.affiliation: Süleyman Demirel University, Faculty of Medicine, Department of Urology, Isparta, Turkey.
authors.forename: Ercan
authors.initials: E
authors.lastname: Baş
authors.affiliation: Süleyman Demirel University, Faculty of Medicine, Department of Radiology, Isparta, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kara
authors.affiliation: Marmara University, Faculty of Medicine, Department of Urology, Istanbul, Turkey.
authors.forename: Cevdet
authors.initials: C
authors.lastname: Kaya
keywords: Doppler ultrasonography; extra-scrotal fixation; manual detorsion; scrotal exploration; testicular torsion