通过血清抑制素B水平评估单侧睾丸扭转后对侧睾丸损伤情况。

Evaluation of contralateral testicular damage after unilateral testicular torsion by serum inhibin B levels.

作者信息

Ozkan K U, Küçükaydin M, Muhtaroğlu S, Kontaş O

机构信息

Department of Pediatric Surgery, Erciyes University Medical Faculty, Kayseri, Turkey.

出版信息

J Pediatr Surg. 2001 Jul;36(7):1050-3. doi: 10.1053/jpsu.2001.24742.

Abstract

BACKGROUND/PURPOSE: It is still controversial whether unilateral testicular torsion (TT) affects contralateral testis. The authors wanted to evaluate contralateral testicular damage in a rat model by the serum inhibin B levels, which is suggested as a marker of Sertoli cell function and spermatogenesis.

METHODS

Fifty peripubertal male Wistar Albino rats were divided into 5 groups each containing 10 rats. Surgery was conducted under intraperitoneal 1-shot ketamine (50 mg/kg) anesthesia. Torsion-detorsion, torsion-detorsion-orchiectomies, orchiectomies, and sham operations were performed on the right testicle through a midline incision. Torsions were created by rotating the right testes 720 degrees in a clockwise direction and maintained by fixing the testes to the scrotum with a silk suture. Torsion duration was 4 hours. After each surgical intervention the incisions were closed. In group 1, 3-mL blood samples were taken to determine basal values of inhibin B in serum, and bilateral orchiectomies were performed. In group 2, 4 hours of torsion and detorsion was created and 1 month later, 3-mL blood samples were taken, and bilateral orchiectomies were performed. In group 3, 4 hours of torsion-4 hours of detorsion was created, and right orchiectomies were performed and 1 month later, 3-mL blood samples were taken and contralateral orchiectomies were added. In group 4, unilateral orchiectomies were performed, and 1 month later, 3-mL blood samples were taken, and contralateral orchiectomies were added. After the measurement of the serum inhibin B levels and histopathologic examinations, results are expressed as mean +/- SD.

RESULTS

Serum inhibin B levels expressed as mean +/- SD were 108.233 +/- 21.296 pg/mL for group 1, 54.065 +/- 16.910 pg/mL for group 2, 74.195 +/- 2.779 pg/mL for group 3, 108.335 +/- 26.078 pg/mL for group 4, and 107.645 +/- 4.705 pg/mL for group 5. Inhibin B levels in group 2 and group 3 were different from group 1, group 4, and group 5 (P <.05). In histologic examination, Johnsen's scores expressed as mean +/- SD of right testes were 9.74 +/- 0.08 for group 1, 3.64 +/- 3.36 for group 2, and 9.86 +/- 0.05 for group 5. Histologic findings in group 2 were different from group 1 and group 5 (P <.05). Johnsen's scores expressed as mean +/- SD of left testes were 9.78 +/- 0.09 for group 1, 9.75 +/- 0.14 for group 2, 9.76 +/- 0.15 for group 3, 9.79 +/- 0.07 for group 4, and 9.82 +/- 0.08 for group 5, and there was no difference between groups (P >.05).

CONCLUSIONS

The serum inhibin B levels decrease after unilateral TT reflecting contralateral testicular damage. Orchiectomy to prevent contralateral testicular damage after TT may not be effective after critical period. Measurement of inhibin B levels to evaluate contralateral testicular damage after unilateral TT is more effective than histopathologic examination.

摘要

背景/目的:单侧睾丸扭转(TT)是否会影响对侧睾丸仍存在争议。作者希望通过血清抑制素B水平评估大鼠模型中的对侧睾丸损伤,血清抑制素B被认为是支持细胞功能和精子发生的标志物。

方法

将50只青春期前雄性Wistar白化大鼠分为5组,每组10只。手术在腹腔注射一次性氯胺酮(50 mg/kg)麻醉下进行。通过中线切口对右侧睾丸进行扭转-复位、扭转-复位-睾丸切除术、睾丸切除术和假手术。通过将右侧睾丸顺时针旋转720度造成扭转,并用丝线缝合将睾丸固定在阴囊上来维持扭转状态。扭转持续时间为4小时。每次手术干预后关闭切口。在第1组中,采集3 mL血样以测定血清中抑制素B的基础值,并进行双侧睾丸切除术。在第2组中,造成4小时的扭转和复位,1个月后,采集3 mL血样,并进行双侧睾丸切除术。在第3组中,造成4小时的扭转-4小时的复位,然后进行右侧睾丸切除术,1个月后,采集3 mL血样并进行对侧睾丸切除术。在第4组中,进行单侧睾丸切除术,1个月后,采集3 mL血样并进行对侧睾丸切除术。在测量血清抑制素B水平和组织病理学检查后,结果以平均值±标准差表示。

结果

第1组血清抑制素B水平以平均值±标准差表示为108.233±21.296 pg/mL,第2组为54.065±16.910 pg/mL,第3组为74.195±2.779 pg/mL,第4组为108.335±26.078 pg/mL,第5组为107.645±4.705 pg/mL。第2组和第3组的抑制素B水平与第1组、第4组和第5组不同(P<.05)。在组织学检查中,右侧睾丸的约翰森评分以平均值±标准差表示,第1组为9.74±0.08,第2组为3.64±3.36,第5组为9.86±0.05。第2组的组织学结果与第1组和第5组不同(P<.05)。左侧睾丸的约翰森评分以平均值±标准差表示,第1组为9.78±0.09,第2组为9.75±0.14,第3组为9.76±0.15,第4组为9.79±0.07,第5组为9.82±0.08,各组之间无差异(P>.05)。

结论

单侧TT后血清抑制素B水平降低反映了对侧睾丸损伤。在关键期过后,为预防TT后对侧睾丸损伤而进行的睾丸切除术可能无效。测量抑制素B水平以评估单侧TT后对侧睾丸损伤比组织病理学检查更有效。

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