Kırıkkale University, Medical Faculty, Department of Pediatric Surgery, Kırıkkale, Turkey.
J Pediatr Urol. 2013 Dec;9(6 Pt A):940-4. doi: 10.1016/j.jpurol.2013.01.005. Epub 2013 Jan 29.
Although absent cremasteric reflex is a significant clinical finding for testicular torsion (TT), there is limited information about microcirculation of the cremasteric muscle (CM) after TT. This experimental study was performed to evaluate CM microcirculation by intravital microscopy after TT.
Twelve Wistar rats were allocated into two equal groups: control (CG) and torsion (TG). After anesthetization of the CG rats, the CM flap was dissected through a left ventral inguinal incision with its vascular pedicle. In TG rats, TT was performed by rotating left testicles 720(°) in clockwise direction for 1 h. Then, the CM flap was dissected as in CG, and was placed under an intravital microscope. Vessel diameters, functional capillary perfusion and leukocyte activation in post-capillary venules were measured and evaluated statistically.
There was a significant decrease in vessel diameter in TG compared to CG (p < 0.05). The median of perfused capillaries in CG and TG was 13 (11.75-14.30) and 5.5 (4.75-7.25), respectively (p < 0.05). Number of granulocytes (rolling, sticking, transmigrated) was greater in TG than CG (p < 0.05).
Intravital microscopic evaluation of CM after TT showed decrease in vessel diameter and number of perfused capillaries, and increase in granulocyte activation. Clinical, electrophysiological alterations in CM after TT can be explained by deterioration of microcirculation of CM.
尽管提睾反射缺失是睾丸扭转(TT)的重要临床发现,但关于 TT 后提睾肌(CM)的微循环知之甚少。本实验研究通过活体显微镜评估 TT 后 CM 的微循环。
将 12 只 Wistar 大鼠随机分为两组:对照组(CG)和扭转组(TG)。CG 大鼠麻醉后,通过左腹股部的一个小切口,游离并保留 CM 皮瓣及其血管蒂。在 TG 大鼠中,顺时针旋转左侧睾丸 720(°)进行 TT,持续 1 小时。然后,按照 CG 的方法游离 CM 皮瓣,并置于活体显微镜下。测量并统计后微静脉中血管直径、功能性毛细血管灌注和白细胞激活。
与 CG 相比,TG 的血管直径明显减小(p<0.05)。CG 和 TG 的灌注毛细血管中位数分别为 13(11.75-14.30)和 5.5(4.75-7.25)(p<0.05)。TG 中滚动、黏附、迁移的粒细胞数多于 CG(p<0.05)。
TT 后 CM 的活体显微镜评估显示血管直径和灌注毛细血管数量减少,粒细胞激活增加。CM 临床和电生理改变可以用 CM 微循环恶化来解释。