Department of Urology, Karadeniz Technical University, School of Medicine, 61080 Trabzon, Turkey.
J Pediatr Surg. 2012 Sep;47(9):1716-23. doi: 10.1016/j.jpedsurg.2012.01.078.
Ischemia reperfusion injury arising from testicular torsion results in a loss of spermatogenesis and a significant increase in germ cell apoptosis. We investigated the effects of dipyridamole and acetylsalicylic acid (ASA), 2 well-known platelet inhibitors, on testicular ischemia reperfusion injury.
Thirty adult male Sprague-Dawley rats were randomly divided into 5 groups (n = 6 for each group): control, sham-operated, torsion/detorsion (T/D), T/D + dipyridamole, and T/D + ASA. Testicular ischemia was achieved by rotating the left testis 720° clockwise for 2 hours. Thirty minutes before torsion, 10 mg/kg dipyridamole was injected transperitoneally in the T/D + dipyridamole group, and 100 mg/kg ASA was injected transperitoneally in the T/D + ASA group. Sixty days after the initial surgical procedure, ipsilateral orchiectomies were performed for histopathologic examination to determine Johnsen's mean testicular biopsy score (MTBS), mean seminiferous tubular diameter (MSTD), and apoptotic index (AI) in all groups.
Unilateral testicular torsion-detorsion led to a significant decrease in Johnsen's MTBS and MSTD values in the ipsilateral testis and a significant increase in AI values of the T/D group. There were no significant differences between the T/D + dipyridamole and control groups in terms of MSTD and MTBS values. Although an amount of improvement exits in T/D + ASA group, there were significant differences between the T/D + ASA and control group MSTD and MTBS values. There was no significant difference between the T/D + dipyridamole and control groups in terms of AI values (P > .05), but the differences between the T/D + ASA and control groups were significant despite a slight decline in AI values of the T/D + ASA group.
Our findings show that the use of dipyridamole before testicular reperfusion has a potentially protective effect against long-term injury in testicular ischemia reperfusion injury.
睾丸扭转引起的缺血再灌注损伤导致精子发生丧失和生殖细胞凋亡显著增加。我们研究了两种众所周知的血小板抑制剂双嘧达莫和乙酰水杨酸（ASA）对睾丸缺血再灌注损伤的影响。
30 只成年雄性 Sprague-Dawley 大鼠随机分为 5 组（每组 6 只）：对照组、假手术组、扭转/复位组（T/D）、T/D+双嘧达莫组和 T/D+ASA 组。通过顺时针旋转左睾丸 720° 来实现睾丸缺血。在 T/D+双嘧达莫组中，在扭转前 30 分钟经腹膜内注射 10mg/kg 双嘧达莫，在 T/D+ASA 组中经腹膜内注射 100mg/kg ASA。初次手术 60 天后，进行同侧睾丸切除术，进行组织病理学检查，以确定所有组的 Johnsen 平均睾丸活检评分（MTBS）、平均生精小管直径（MSTD）和凋亡指数（AI）。
单侧睾丸扭转-复位导致同侧睾丸的 Johnsen MTBS 和 MSTD 值显著降低，AI 值显著升高。T/D+双嘧达莫组与对照组在 MSTD 和 MTBS 值方面无显著差异。T/D+ASA 组虽然有一定程度的改善，但 T/D+ASA 组与对照组的 MSTD 和 MTBS 值仍有显著差异。T/D+双嘧达莫组与对照组在 AI 值方面无显著差异（P＞.05），但 T/D+ASA 组与对照组的差异显著，尽管 T/D+ASA 组的 AI 值略有下降。
我们的研究结果表明，在睾丸再灌注前使用双嘧达莫具有潜在的保护作用，可以预防睾丸缺血再灌注损伤的长期损伤。
