Acute global testicular infarction: A rare and important complication after endovascular abdominal aortic aneurysm repair.

Testicular ischemia is one of the most rarely reported complications of endovascular abdominal aortic aneurysm repair (EVAR). Although the pathogenesis remains unclear, thromboembolic events in the setting of testicular artery origin occlusion by the stent graft and poor baseline collateral testicular circulation are presumed causes. A 73-year-old man developed acute right testicular infarction 3 days after EVAR, requiring orchiectomy. This case emphasizes the importance of recognizing and evaluating testicular pain after EVAR and counseling patients on this possible EVAR complication.

The diagnostic role of testicular fatty acid-binding protein in testicular ischemia: a randomized controlled experimental study / El papel diagnóstico de la proteína fijadora de ácidos grasos testiculares en la isquemia testicular: un estudio experimental controlado aleatorizado

Objetive: To investigate the diagnosticvalue of testicular fatty acid-binding protein (T-FABP) inacute testicular ischemia and prolonged ischemia.Methods: The study included a total of 28 prepubertal male Wistar-Hannover rats. The animals were randomly divided into 4 groups as torsion groups (group I;min 30; 7 rats, group II; min 120; 7 rats, group III; min240; 7 rats) and control group (group IV; 7 rats). In eachgroup, the left testis was separated from the gubernaculum by blunt dissection together with the tunica vaginalisand spermatic cord, and then exposed. In the controlgroup, the blood samples and left testicular tissues were collected at min 240 after extraction. In torsion groups,the left testis was rotated together with its cord elements,720° in a clockwise direction for the induction of an extravaginal TT model. The blood samples were obtainedat min 30, 120, and 240 in the torsion groups. Bilateraltesticular tissues were collected via orchiectomy for histopathological examination in all groups.Results: The mean plasma T-FABP level in group III (torsion, min 240) was significantly higher than those ofother groups. The T-FABP level at min 240 had a sensitivity and specificity of 100% and 85%, respectively, ata cut-off value of 1.059. A significant difference wasfound between the torsion groups and the control groupwith regard to histopathological scores.Conclusions: The increased T-FABP levels in testicular ischemia seem to be correlated with testicular necrosis rather than acute ischemia.(AU)

Objetivo: Investigar el valor diagnosticode la proteína testicular acido graso (PTAG) en la isquemia testicular aguda y prolongada.Métodos: El estudio involucro 28 ratas Wastar-Hannover varones prepuberales. Los animales fueron randomizados y divididos en 4 grupos: grupo torsión (grupoI; min 30; 7 ratas, grupo II; min 120; 7 ratas, grupoIII; min 240; 7 ratas), grupo control (grupo IV; 7 ratas).En cada grupo, el testículo izquierdo fue separado delgubernáculo con disección, junto con la túnica vaginalisy el cordón espermático, y después fueron expuestos.En el grupo control, la extracción de sangre y tejidotesticular izquierdo fueron recolectados a los 240 minutos de la extracción. En el grupo de torsión, el testículoizquierdo se rotó junto con los elementos del cordónespermático, 720 grados en la dirección de las agujasdel reloj para la inducción de un modelo TT extravaginal. Las muestras de sangre fueron obtenidas a los30 minutos, 120 y 240 minutos en los grupos torsión.Tejido testicular bilateral fue recogido vía orquiectomiapara examen anatomopatológico en todos los grupos.Resultados: El nivel medio de PTAG en el grupo III(torsión 240 min) fue significativamente superior a losdemás grupos. El nivel de PTAG a los 240 minutos tuvouna sensibilidad y especificidad del 100% y 85%, respectivamente a un valor de corte de 1.059. Se encontróuna diferencia significativa entre los grupos de torsión ycontrol en relación a los “scores” anatomopatológicos.Conclusiones: Los niveles elevados de PTAG enla isquemia testicular parecen correlacionados con lanecrosis testicular más que con la isquemia aguda.(AU)

The Change of Histologic Features and Eicosanoids Level in Rat Testicular Ischemia-Reperfusion Injury / 대한비뇨기과학회지

PURPOSE: It has been suggested that prostaglandins (PGs) play an important role in ischemia-reperfusion (IR) organ injury. However, the significance of PGs is not well documented for a testicular IR injury. The purpose of this study was to assess the potential role of PGs in rat testicular ischemia and IR injury MATERIALS AND METHODS: Sprague-Dawley male rats were divided into 7 groups, each containing 7 rats. The right spermatic cord was clamped with vascular clamps for 30 minute (group B, C), 90 minute (D, E) and 240 minute (F, G). Groups B, D, and F were ischemia groups and the group C, E, and G were reperfusion groups. Reperfusion was carried out after ischemia lasting 30, 90 and 240 min. The levels of thromboxane B2 (TxB2), 6-keto-PGF1alpha and prostaglandins E2 (PGE2) were measured using High-Performance Liquid Chromatography (HPLC). RESULTS: The levels of TxB2 were significantly elevated in groups D, E, F, and G than in the controls (p<0.05, each group). The TxB2 levels in the ischemia group F were significantly decreased compared to that of group D (p<0.05). The histological features shown in groups D, and F were typical ischemic changes, but atypical in groups B, and C. The most severe damage was noted in group G. These features were well matched with the changes of TxB2 in testicular ischemia and IR injury. The levels of 6-keto-PGF1alpha were significantly elevated in all the ischemia and IR groups compared to that of the controls (p<0.05). CONCLUSIONS: These results suggested that TxB2 might have an active role in testicular IR injury, although PGE2 and 6-keto-PGF1alpha seemed not to have an active role.

Effect of mannitol on testicular ischemia-reperfusion injury: An experimental an

Objective: To determine the effect of mannitol in reducing testicular damage after ischemia-reperfusion (I-R) injury in rabbitsMaterials and Methods: three groups of male rabbits were included in the study: 1. Baseline group (n=6), underwent bilateral orchiectomy to serve as baseline; 2. Control group (n=24), testicular torsion simulated for 4 hours; 3 Mannitol group (n=24), testicular torsion simulated for 4 hours and mannitol administered during the last 30 minutes of ischemia. The latter two (2) groups underwent bilateral orchiectomy after one week. Architecture and germinal epithelial cell thickness were determined by histological examination on each testis. Average thickness (in cell layers) of the mannitol group was compared with control group using the T-testResults: The mannitol group showed a significant increase in epithelial cell thickness compared with control group (4.8 +/- 0.09 versus 3.0 +/- 0.1 cell layers, p0.01)Conclusion: Mannitol therapy administered during testicular ischemia-reperfusion injury significantly reduced damage to the testis in this animal model. (Author)

A study on the effects hypothermia in the initial phase and hyperthermia in the recovery phase on ischemia-induced testicular injury / 대한비뇨기과학회지

Even though the ischemic change induced by the testicular torsion has been studied extensively, there is a few available information about the prevention or reduction of testicular injury during vascular insufficiency. We studied the effect of hypothermia on prevention of the ischemia-induced damage and the effect of hyperthermia on the recovery of the damage during re-perfusion of blood after ischemia ended. The four groups of Sprague-Dawley rats were subjected to varying duration of bilateral testicular ischemia. In the first group, both testes underwent ischemia for 2, 4 and 6 hours at room temperature. The second group underwent ischemia for 30 minutes at room temperature and then for 1.5. 3.5 and 5.5 hours at 4 degrees C ice bath. In the third group, testes underwent the procedure described in the first group and then were immersed in 41 degrees C water for 30 minutes during re-perfusion of blood. The fourth group underwent the procedure described in the second group and then were immersed in 41 degrees C water for 30 minutes during re-perfusion of blood. Bilateral orchiectomy was performed after lapse of 2 weeks. Histology of testes of all groups was compared. Neither group revealed significant destruction of germinal epithelium after two hours of ischemia. However, the preservation rates of germinal epithelium in the first group were 25% and 8.3% at four and six hours or ischemia, when compared with the control group, which were statistically significant(p0.05). In conclusion, when ischemia was induced by testicular torsion. the damage of testicular tissue could be prevented or arrested to a certain degree by external ice application. However, it might be proposed that hyperthermia did not enhance the recovery of the damaged testes after re-perfusion of blood.