Shojaeian Reza, Hiradfar Mehran, Bahrami Taqanaki Pegah, Khorsand Ahmadi Sarina, Jelveh Masouleh Yousef, Ameri Leila, Parvizi Mashhadi Mahdi
Department of Pediatric Surgery.
Akbar Children's Hospital.
Ann Med Surg (Lond). 2023 Jun 17;85(8):3906-3911. doi: 10.1097/MS9.0000000000000976. eCollection 2023 Aug.
One of the ways to treat undescended testicles is to use orchiopexy surgery, which is modified into the two-stage Fowler-Stephens technique in cases of short or immobile testes. The disadvantage of using this technique is the probability of testicular ischaemia following the sudden closure of the testicular artery; although the collateral arteries prevent atrophy, the testis loses its germ cells during this stress and may no longer be functional. Therefore, this study aims to examine the changes in testicular tissue regarding necrosis and infarction after the occlusion of the vessels.
In this experimental study 15 male rats weighing 200-250 g were prepared and first, one of the rats was sacrificed and testicles on both sides were used for pathology control. After general anaesthesia vascular ligature was performed with the left testes undergoing both venous and arterial occlusion and the right testes only arterial occlusion. After 1 month, all specimens were killed and the testes were completely removed and sent for histopathological evaluation.
A total of 14 rats and 28 testes were studied in two equal groups of case and control. There was no significant difference between the case and control groups in terms of testicular volume, consistency, and viability. Microscopic findings revealed that necrosis, infarction, and state of inflammation were significantly higher in the case group than in the control group.
The results of this study show that abrupt closure of the testicular artery in rats is associated with necrosis and infarction, decreased spermatogenesis, and more inflammation. However, no significant differences were found in terms of macroscopic findings including volume, consistency, and viability.
治疗隐睾的方法之一是采用睾丸固定术，对于睾丸短小或无法移动的病例，该手术可改良为两阶段的福勒 - 斯蒂芬斯技术。使用该技术的缺点是睾丸动脉突然闭合后发生睾丸缺血的可能性；尽管侧支动脉可防止萎缩，但睾丸在这种应激状态下会失去生殖细胞，可能不再具备功能。因此，本研究旨在检查血管闭塞后睾丸组织在坏死和梗死方面的变化。
在这项实验研究中，准备了15只体重200 - 250克的雄性大鼠，首先处死其中一只大鼠，两侧睾丸用于病理对照。全身麻醉后进行血管结扎，左侧睾丸同时进行静脉和动脉闭塞，右侧睾丸仅进行动脉闭塞。1个月后，处死所有标本，完整切除睾丸并送去进行组织病理学评估。
在病例组和对照组两个相等的组中，共研究了14只大鼠和28个睾丸。病例组和对照组在睾丸体积、质地和活力方面没有显著差异。显微镜检查结果显示，病例组的坏死、梗死和炎症状态明显高于对照组。
本研究结果表明，大鼠睾丸动脉的突然闭塞与坏死、梗死、精子发生减少和更多炎症相关。然而，在包括体积、质地和活力等宏观检查结果方面未发现显著差异。
