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Ganjiani V, Meimandi-Parizi A, Ahmadi N, Sharifiyazdi H, Divar MR. Evaluation of effects of Tempol on testicular ischemia/reperfusion injury. Am J Emerg Med 2024; 82:107-116. [PMID: 38901331 DOI: 10.1016/j.ajem.2024.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/28/2024] [Accepted: 06/11/2024] [Indexed: 06/22/2024] Open
Abstract
AIM Tempol, a synthetic antioxidant compound, has received significant attention for its potential therapeutic applications in recent years, especially against ischemia/reperfusion (I/R) injury. The aim of the present research was to assess the protective effects of Tempol on testicular I/R injury caused by testicular torsion and detorsion (T/D) in rats. METHODS The subjects were divided into five groups: sham, testicular T/D, testicular T/D with Tempol treatment at 50 and 100 mg/kg, and healthy rats treated with Tempol at 100 mg/kg. Testicular torsion was induced by rotating the left testicles for 2 h, followed by detorsion for 24 h. Testicular tissues were evaluated for gene expression, oxidative stress markers, and histopathology, epididymal sperms were stained and analyzed, and blood serum samples were collected to measure the testosterone hormone. RESULTS The results showed that testicular I/R caused a significant decrease in sperm velocity parameters, viability, and count, as well as an increase in abnormal sperms (p < 0.05). However, treatment with Tempol significantly improved these parameters (p < 0.05). Histopathological analysis revealed severe damage to the testicular tissues, but treatment with Tempol improved the structural integrity of the seminiferous tubules. Testicular I/R also resulted in increased oxidative stress index and decreased testosterone levels significantly (p < 0.05), but Tempol administration mitigated these effects significantly (p < 0.05). Furthermore, the expression of Bax and Bcl2, genes associated with apoptosis, were significantly altered by testicular I/R (p < 0.05), but Tempol prevented these changes significantly (p < 0.05). CONCLUSION These findings provide strong evidence that Tempol can effectively prevent testicular I/R injury.
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Affiliation(s)
- Vahid Ganjiani
- Department of Clinical Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | | | - Nasrollah Ahmadi
- Department of Pathobiology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Hassan Sharifiyazdi
- Department of Clinical Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
| | - Mohammad-Reza Divar
- Department of Clinical Sciences, School of Veterinary Medicine, Shiraz University, Shiraz, Iran
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Murali TV, Jaya KV, Kumar R. Testicular torsion - symptomatology and outcomes of 101 scrotal explorations. Urol Ann 2022; 14:167-171. [PMID: 35711480 PMCID: PMC9197001 DOI: 10.4103/ua.ua_142_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 12/21/2020] [Indexed: 11/18/2022] Open
Abstract
Objective: The objective was to study the symptomatology of testicular torsion of patients operated in our hospital and their operative results in relation to the duration of symptoms. Materials and Methods: Data of all patients operated for acute scrotum at all ages over a 14 months’ time were collected from hospital records. Symptomatology and operative results were studied. Results: Out of 101 consecutive scrotal explorations done in this time, 63.4% of all scrotal explorations were testicular torsion (n = 64). 22.8% were appendage torsion (n = 23) and 13.9% were epididymo-orchitis (n = 14). The peak age of testicular torsion was in the 11–15 years range and the left side is more common (65.6%). Symptoms of scrotal pain (92.2%), abdominal pain (18.8%), nausea/vomiting (18.8%), fever (9.4%), and urinary symptoms (3.1%) were seen in decreasing order of frequency. Among acute scrotum patients who had symptoms of nausea/vomiting or abdominal pain, testicular torsion was found to be significantly higher compared to those who did not have these symptoms (χ2 = 0.044, P < 0.05). In all cases presented within 6 h of symptom onset, testicles were saved and salvage rates reduced with delay in presentation. The testicular salvage rates were 28.1% (18 out of 64 torsions). Patients below 18 years had more chance of going for orchiectomy than others (75% vs 66.7%). Patients who presented after 24 h had a statistically significantly lower salvage rate of 7.7% compared to those who presented within 24 h duration, 52.2%(χ2 = 0.001, P < 0.05). Those with orchiopexy had a median duration of symptom of 6.5 h and the same for orchiectomy patients were 72 h. Our median symptom duration for testicular torsion was 36 h and it is higher than many other countries. Conclusions: Delay in presentation to the health-care facility is the major cause of poor salvage rates in the state and its improvement requires public health interventions and health education.
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Xu Z, Wu J, Ni S, Luo H. The diagnostic value of ultrasound in pediatric testicular torsion with preserved flow. Front Pediatr 2022; 10:1001958. [PMID: 36245726 PMCID: PMC9554414 DOI: 10.3389/fped.2022.1001958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/07/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Testicular torsion is the reduction of blood flow to the testis after spermatic cord torsion. For patients, the diagnosis of testicular torsion is controversial and complicated by the fact that ultrasound blood flow signals are not significantly reduced in comparison to the unaffected, healthy, testis, despite persistent symptoms on the affected side. Our study aims to investigate the diagnostic characteristics of high-resolution ultrasonography (US) in pediatric testicular torsion with the preserved flow to increase diagnostic accuracy. METHODS Seven pediatric patients aged 49 days to 15 years old, with the preserved blood flow, but surgically diagnosed as testicular torsion, from October 2017 to August 2019, were retrospectively included in the study. The imaging manifestations of high-frequency ultrasonography were evaluated. RESULTS All cases had preserved testicular blood flow, but the surgical findings showed various degrees of twist, from 90 to 540 degrees. Preoperative ultrasound showed spermatic cord distortion in all cases, and testicular long axis tilting in four cases (4/7 = 57.1%). CONCLUSION In some testicular torsion cases, Color Doppler may show normal or increased blood flow signals in the testis. We should further observe the morphology and position of the testes and epididymides, the echo of the testicular parenchyma, and, especially evaluate the "whirlpool sign" in the spermatic cord, to avoid missing testicular torsion with blood flow signals.
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Affiliation(s)
- Zhihua Xu
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Junbo Wu
- Department of Children's Ultrasound Imaging, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuangshuang Ni
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hongxia Luo
- Department of Ultrasonic Diagnosis, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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Hamza BK, Ahmed M, Tolani MA, Awaisu M, Lawal AT, Oyelowo N, Bello A, Maitama HY. Spectrum of urological emergencies and surgical interventions in a single tertiary health center. Afr J Emerg Med 2021; 11:223-226. [PMID: 33680746 PMCID: PMC7905443 DOI: 10.1016/j.afjem.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 01/22/2021] [Accepted: 02/02/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives Emergency urologic conditions are relatively common, albeit rarely life threatening, there is often a need for prompt and expedient management in order to avert severe or permanent morbidities. This study aimed to evaluate the spectrum of Urologic emergencies and interventions offered in a tertiary hospital in Nigeria. Patients and methods We retrospectively reviewed the records of patients who were managed in our institution for emergency urologic conditions over a period of 6 years (2011-2017). The data extracted included; the demographic information, diagnosis and the treatment offered. The data obtained were analyzed using SPSS version 20. Data were displayed using mean +/- standard deviation and percentages. Results The records of a total of 681 patients were retrieved and they span across almost all ages with age range or 2-90 years. Urinary retention was the commonest emergency seen, accounting for 51.7% of the patients. Testicular torsion was the next most common (10%), others are bilateral ureteric obstruction and priapism with 5.4% and 5.3% respectively. Suprapubic cystostomy (SPC) was the commonest operative procedure performed (37.6%). The age range for patients with urinary retention was 3-90 years, though the peak incidence was in the 7th decade (37.3%). Patients with testicular torsion were young adults between the ages of 11 and 44 years. Conclusion Urinary retention was the commonest urologic emergency followed by testicular torsion. Though urethral catheterization was successful in most patients urinary retention, making it the commonest procedure. SPC was the commonest emergency operative procedure performed. Other emergencies occurred sporadically.
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Affiliation(s)
- Babatunde K Hamza
- Kaduna State University, Nigeria
- Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Muhammed Ahmed
- Kaduna State University, Nigeria
- Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Musliu Adetola Tolani
- Kaduna State University, Nigeria
- Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Mudi Awaisu
- Kaduna State University, Nigeria
- Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Ahmad Tijjani Lawal
- Kaduna State University, Nigeria
- Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Nasir Oyelowo
- Kaduna State University, Nigeria
- Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Ahmad Bello
- Kaduna State University, Nigeria
- Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
| | - Hussein Yusuf Maitama
- Kaduna State University, Nigeria
- Ahmadu Bello University Teaching Hospital, Zaria, Nigeria
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Beaud N, Kanbar A, Abdessater M. Anatomical risk factors for spermatic cord torsion and their involvement in the choice of orchidopexy technique. Morphologie 2020; 105:1-9. [PMID: 32919902 DOI: 10.1016/j.morpho.2020.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 06/09/2020] [Accepted: 06/12/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We aim by this article to present a literature review on the anatomical risk factors for spermatic cord torsion and their involvement the different techniques of orchidopexy. MATERIALS AND METHODS The literature review was conducted following PRISMA check-list, using PubMed database and the Mesh terms: testis, torsion, anomaly, orchidopexy. Techniques of surgical management provided by the EMC (French medico-surgical encyclopedia) were also used. RESULTS Database research identified 500 articles, and 16 mores articles were added from the review of the references lists of relevant articles. At the end, 42 articles were useful for our review including 6 reviews, 5 cross-sectional studies, 14 cohorts, 10 case reports, 1 meta-analysis, 1 letter, and 5 experimental studies. High insertion of the tunica vaginalis, a long mesorchium, deficient attachment of the epididymis to the testis, and anomalies of the gubernaculum testis are the anatomical predispositions for spermatic cord torsion. After reduction of torsion, many surgical techniques for the fixation of the testis have been suggested including: conventional technique by triangulation with or without fasciotomy, window orchidopexy, scrotal pouch, and vaginal eversion with or without dartos fixation. CONCLUSION The most common anatomical factor associated with spermatic cord torsion is the high insertion of the tunica vaginalis. Vaginal eversion with fixation to the dartos might be superior to other known techniques and seems promising to become standard.
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Affiliation(s)
- Nicolas Beaud
- Sorbonne Université, AP-HP, Hôpital Universitaire La Pitié-Salpêtrière, 75013 Paris, France
| | - Anthony Kanbar
- Sorbonne Université, AP-HP, Hôpital Universitaire La Pitié-Salpêtrière, 75013 Paris, France
| | - Maher Abdessater
- Sorbonne Université, AP-HP, Hôpital Universitaire La Pitié-Salpêtrière, 75013 Paris, France.
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He Y, Bhoopathy V, Gerlach J, Myint M, McCombie S, Ko R. Case of intermittent testicular torsion and de-torsion captured on scrotal ultrasound. ANZ J Surg 2020; 91:E135-E136. [PMID: 32761856 DOI: 10.1111/ans.16161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Yilu He
- Nepean Urology Research Group, Nepean Hospital, Sydney, New South Wales, Australia
| | - Varun Bhoopathy
- Nepean Urology Research Group, Nepean Hospital, Sydney, New South Wales, Australia
| | - Jenni Gerlach
- Nepean Diagnostics, Sydney, New South Wales, Australia
| | - Michael Myint
- Nepean Urology Research Group, Nepean Hospital, Sydney, New South Wales, Australia
| | - Steve McCombie
- Nepean Urology Research Group, Nepean Hospital, Sydney, New South Wales, Australia
| | - Raymond Ko
- Nepean Urology Research Group, Nepean Hospital, Sydney, New South Wales, Australia
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Abu S, Atim T, Obiategwu KO, Okpako IO, Magnus FE. Does the source of referral affect the outcomes of testicular torsion? NIGERIAN JOURNAL OF MEDICINE 2020. [DOI: 10.4103/njm.njm_135_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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