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Tunica albuginea decompression fails to alter the injury of prolonged arterial occlusion during testicular torsion.
J Urol. 2013 Jul; 190(1):239-43.JU

Abstract

PURPOSE

The correlation between intratesticular pressure during torsion/detorsion and subsequent testicular function and viability has been reported in several recent studies. We assessed the impact of tunica albuginea incision with tunica vaginalis flap coverage on intratesticular pressure and future histopathological parameters in a rat testicular torsion model.

MATERIALS AND METHODS

A total of 21 rats were divided into 3 groups. Group 1 consisted of 7 controls undergoing a sham operation, group 2 consisted of 7 animals undergoing torsion-detorsion, and group 3 consisted of 7 animals undergoing testicular torsion-detorsion followed by tunica albuginea incision and tunica vaginalis flap coverage. Torsion was created by 720-degree counterclockwise rotation of the left testis for 2 hours. By using a compartment monitor, the intratesticular pressure of the torsed testes was measured before torsion (pre-torsion), immediately before torsion repair (pre-detorsion), 5 minutes after detorsion (post-detorsion), and after tunical incision and tunica vaginalis flap application. The correlations between intratesticular pressure values and testicular weight, modified Johnsen score and mean seminiferous tubule diameter were evaluated 4 weeks postoperatively.

RESULTS

Median pre-detorsion intratesticular pressure was significantly decreased after detorsion in group 2 (21 vs 7 mm Hg, p <0.001) and group 3 (23 vs 7 mm Hg, p = 0.001). In addition, median intratesticular pressure after tunica albuginea incision and tunica vaginalis flap coverage in group 3 was significantly less compared to median post-detorsion intratesticular pressure in group 2 (5 vs 7 mm Hg, p = 0.025). Overall no significant difference was detected between groups 2 and 3 regarding median modified Johnsen score, mean seminiferous tubule diameter or median testicular weight. The significant reduction of intratesticular pressure in group 3 did not correlate with testicular weight (r = 0.500, p = 0.391), modified Johnsen score (r = -0.205, p = 0.741) or mean seminiferous tubule diameter (r = -0.200, p = 0.747).

CONCLUSIONS

Tunica albuginea decompression with tunica vaginalis flap coverage is an effective technique for decreasing intratesticular pressure in torsed testes. However, this technique failed to alter the injury of prolonged arterial occlusion in testicular torsion.

Authors+Show Affiliations

Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. tayfunoktar@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

23313196

Citation

Oktar, Tayfun, et al. "Tunica Albuginea Decompression Fails to Alter the Injury of Prolonged Arterial Occlusion During Testicular Torsion." The Journal of Urology, vol. 190, no. 1, 2013, pp. 239-43.
Oktar T, Kucukdurmaz F, Erdem S, et al. Tunica albuginea decompression fails to alter the injury of prolonged arterial occlusion during testicular torsion. J Urol. 2013;190(1):239-43.
Oktar, T., Kucukdurmaz, F., Erdem, S., Kilicaslan, I., Ceylan, C., Sanli, O., Unverdi, C. M., & Ziylan, O. (2013). Tunica albuginea decompression fails to alter the injury of prolonged arterial occlusion during testicular torsion. The Journal of Urology, 190(1), 239-43. https://doi.org/10.1016/j.juro.2013.01.012
Oktar T, et al. Tunica Albuginea Decompression Fails to Alter the Injury of Prolonged Arterial Occlusion During Testicular Torsion. J Urol. 2013;190(1):239-43. PubMed PMID: 23313196.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tunica albuginea decompression fails to alter the injury of prolonged arterial occlusion during testicular torsion. AU - Oktar,Tayfun, AU - Kucukdurmaz,Faruk, AU - Erdem,Selcuk, AU - Kilicaslan,Isın, AU - Ceylan,Canan, AU - Sanli,Oner, AU - Unverdi,Cenk Murat, AU - Ziylan,Orhan, Y1 - 2013/01/09/ PY - 2013/01/04/accepted PY - 2013/1/15/entrez PY - 2013/1/15/pubmed PY - 2013/8/24/medline SP - 239 EP - 43 JF - The Journal of urology JO - J Urol VL - 190 IS - 1 N2 - PURPOSE: The correlation between intratesticular pressure during torsion/detorsion and subsequent testicular function and viability has been reported in several recent studies. We assessed the impact of tunica albuginea incision with tunica vaginalis flap coverage on intratesticular pressure and future histopathological parameters in a rat testicular torsion model. MATERIALS AND METHODS: A total of 21 rats were divided into 3 groups. Group 1 consisted of 7 controls undergoing a sham operation, group 2 consisted of 7 animals undergoing torsion-detorsion, and group 3 consisted of 7 animals undergoing testicular torsion-detorsion followed by tunica albuginea incision and tunica vaginalis flap coverage. Torsion was created by 720-degree counterclockwise rotation of the left testis for 2 hours. By using a compartment monitor, the intratesticular pressure of the torsed testes was measured before torsion (pre-torsion), immediately before torsion repair (pre-detorsion), 5 minutes after detorsion (post-detorsion), and after tunical incision and tunica vaginalis flap application. The correlations between intratesticular pressure values and testicular weight, modified Johnsen score and mean seminiferous tubule diameter were evaluated 4 weeks postoperatively. RESULTS: Median pre-detorsion intratesticular pressure was significantly decreased after detorsion in group 2 (21 vs 7 mm Hg, p <0.001) and group 3 (23 vs 7 mm Hg, p = 0.001). In addition, median intratesticular pressure after tunica albuginea incision and tunica vaginalis flap coverage in group 3 was significantly less compared to median post-detorsion intratesticular pressure in group 2 (5 vs 7 mm Hg, p = 0.025). Overall no significant difference was detected between groups 2 and 3 regarding median modified Johnsen score, mean seminiferous tubule diameter or median testicular weight. The significant reduction of intratesticular pressure in group 3 did not correlate with testicular weight (r = 0.500, p = 0.391), modified Johnsen score (r = -0.205, p = 0.741) or mean seminiferous tubule diameter (r = -0.200, p = 0.747). CONCLUSIONS: Tunica albuginea decompression with tunica vaginalis flap coverage is an effective technique for decreasing intratesticular pressure in torsed testes. However, this technique failed to alter the injury of prolonged arterial occlusion in testicular torsion. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/23313196/Tunica_albuginea_decompression_fails_to_alter_the_injury_of_prolonged_arterial_occlusion_during_testicular_torsion_ L2 - https://www.jurology.com/doi/10.1016/j.juro.2013.01.012?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -