Turner T T
Department of Urology, University of Virginia Medical School, Charlottesville 22908.
J Urol. 1987 Nov;138(5):1285-90. doi: 10.1016/s0022-5347(17)43585-3.
It is often stated that unilateral testicular torsion results in damage to the contralateral testis; however, there are a growing number of experimental and clinical papers which suggest this is not so. Conflicting results from experimental studies confuse the issue and may be due, among other things, to some specifics of the experimental model. In the present paper, we have examined bilateral rat testes 30 and 60 days after 720 degrees torsion to determine 1) the effect of unilateral testicular torsion with and without the inclusion of epididymal torsion, 2) the effect of relatively chronic torsion (24 hr., 10 day) versus relatively acute torsion (two hr., four hr.), and 3) the effect of establishing the model using scrotal surgery versus using an abdominal approach. Bilateral testicular histology, testis wt. (gm.), cauda epididymal sperm concentrations (sp./ml.), and cauda sperm motility scores (0-4) were examined. Ipsilateral testicular torsion or testicular plus epididymal torsion of two hr. or four hr. duration significantly reduced (p less than .05) ipsilateral testis weights, sperm concentrations, and motility scores, and disrupted normal tissue histology. Contralateral testicles were not altered. Epididymal ischemia alone produced no significant ipsilateral or contralateral effects. Chronic torsion (one day, 10 days) also destroyed ipsilateral testis function without altering the contralateral testicles. The occult cryptorchidism associated with the scrotal approach to establishing the torsion model had no effect on contralateral testicles. In no group, using either Lewis rats or Sprague-Dawley rats, were contralateral testicles altered by unilateral testicular torsion. These results plus recent clinical reports indicate that contralateral testicular damage due to ipsilateral torsion is hardly a proven phenomenon, let alone a significant factor contributing to male infertility.
人们常说单侧睾丸扭转会导致对侧睾丸受损；然而，越来越多的实验和临床论文表明并非如此。实验研究结果相互矛盾，使问题变得复杂，这可能部分归因于实验模型的某些细节。在本文中，我们在720度扭转后30天和60天检查了双侧大鼠睾丸，以确定：1）单侧睾丸扭转（包括或不包括附睾扭转）的影响；2）相对慢性扭转（24小时、10天）与相对急性扭转（2小时、4小时）的影响；3）通过阴囊手术与腹部手术建立模型的影响。检查了双侧睾丸组织学、睾丸重量（克）、附睾尾部精子浓度（精子数/毫升）和附睾尾部精子活力评分（0 - 4）。持续2小时或4小时的同侧睾丸扭转或睾丸加附睾扭转显著降低了（p < 0.05）同侧睾丸重量、精子浓度和活力评分，并破坏了正常组织学结构。对侧睾丸未受影响。单独的附睾缺血对同侧或对侧均未产生显著影响。慢性扭转（1天、10天）也破坏了同侧睾丸功能，但未改变对侧睾丸。与通过阴囊途径建立扭转模型相关的隐匿性隐睾症对对侧睾丸没有影响。在任何一组中，无论是使用刘易斯大鼠还是斯普拉格 - 道利大鼠，单侧睾丸扭转均未改变对侧睾丸。这些结果以及最近的临床报告表明，同侧扭转导致对侧睾丸损伤几乎不是一个已被证实的现象，更不用说它是导致男性不育的一个重要因素了。
