NEÜ Meram Medicine Faculty Department of Urology, Konya, Turkey.
NEÜ Meram Medicine Faculty Department of Pathology, Konya, Turkey.
J Pediatr Urol. 2021 Aug;17(4):440.e1-440.e7. doi: 10.1016/j.jpurol.2021.03.031. Epub 2021 Apr 8.
Testis torsion is a urological emergency and a serious situation that may cause testis atrophy, testicular dysfunction and infertility due to ischaemia/reperfusion(I/R) injury even with early intervention.
To assess the protective effect of dexpanthenol administered intratesticular after detorsion against testis I/R injury.
Twenty-seven rats were randomly divided into 3 groups containing 9 rats each. The 1st group comprised the sham group with no procedure performed. The 2nd group had only torsion applied, while the 3rd group had torsion + dexpanthenol applied. Rats had 720° clockwise rotation applied to the left testis. After 2 h of ischaemia, testes were de-torsioned and the dexpanthenol group had 500 mg/kg dexpanthenol administered intratesticular after detorsion. After 4 h of reperfusion, rats had blood samples taken and orchiectomy was performed for histologic assessment.
A significant difference was detected in all parameters [necrosis(p:<0.001), Cosentino grade (p < 0.001), congestion (p:0.005), fibrosis (p:<0.001), interstitial oedema (p:0.017), JTBS score (p:<0.001), apoptosis (p < 0.001) and testosterone levels (p:0.006)] when the sham, torsion, and torsion + dexpanthenol groups were compared. Significant differences were observed for fibrosis (p:0.010), Cosentino score (p < 0.001), JTBS score (p:<0.001), apoptosis (p:0.001) and total testosterone levels (p:0.013) when torsion and torsion + dexpanthenol groups were compared. The torsion + dexpanthenol group was identified to have more preservation of testis function observed histologically and hormonally compared to the torsion group.
Dexpanthenol is used in many areas due to both epithelizing and antioxidant effects and lack of clear side effects. In spite of use of many chemical and biological agents to protect against testis I/R injury, none have entered routine use. This study showed that dexpanthenol, which can be easily injected intratesticular during detorsion surgery, has protective effect against histological and functional injury that may develop linked to testis I/R injury. The main limitations of the study are short duration of follow-up due to being a rat experiment and lack of comparison of lipid peroxidation products.
This study identified that dexpanthenol with clinically easy use by intratesticular injection after detorsion during surgery had a protective effect against histological and functional injury that will develop linked to I/R injury in the testis.
睾丸扭转是一种泌尿外科急症，如果不及时治疗，可能会导致睾丸缺血再灌注（I/R）损伤，进而引起睾丸萎缩、睾丸功能障碍和不育。
评估去泛醇在睾丸复位后鞘内注射对睾丸 I/R 损伤的保护作用。
27 只大鼠随机分为 3 组，每组 9 只。第 1 组为假手术组，不进行任何操作。第 2 组仅进行扭转，第 3 组进行扭转+去泛醇处理。将大鼠左侧睾丸顺时针旋转 720°。缺血 2 小时后，松解扭转，去泛醇组在松解后鞘内注射 500mg/kg 去泛醇。再灌注 4 小时后，采集血样并进行睾丸切除术以进行组织学评估。
当比较假手术组、扭转组和扭转+去泛醇组时，所有参数[坏死（p：<0.001）、科辛托诺等级（p：<0.001）、充血（p：0.005）、纤维化（p：<0.001）、间质水肿（p：0.017）、JTBS 评分（p：<0.001）、细胞凋亡（p：<0.001）和睾酮水平（p：0.006）]存在显著差异。当比较扭转组和扭转+去泛醇组时，纤维化（p：0.010）、科辛托诺评分（p：<0.001）、JTBS 评分（p：<0.001）、细胞凋亡（p：0.001）和总睾酮水平（p：0.013）也存在显著差异。与扭转组相比，扭转+去泛醇组在组织学和激素水平上表现出更明显的睾丸功能保存。
由于具有上皮化和抗氧化作用，且无明显副作用，去泛醇在许多领域得到了应用。尽管已经使用了许多化学和生物制剂来预防睾丸 I/R 损伤，但没有一种制剂被常规应用。本研究表明，去泛醇在松解扭转时可以很容易地通过鞘内注射，对睾丸 I/R 损伤可能导致的组织学和功能损伤具有保护作用。该研究的主要局限性是由于这是一项大鼠实验，随访时间较短，以及缺乏对脂质过氧化产物的比较。
本研究表明，去泛醇在手术中松解扭转后鞘内注射，具有临床应用的便利性，对睾丸 I/R 损伤后可能发生的组织学和功能损伤具有保护作用。
