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接受手术诱导隐睾下降不全的同侧和对侧睾丸组织缺氧。

Tissue hypoxia in ipsilateral and contralateral testes undergoing surgically induced maldescent.

作者信息

Karnak I, Tanyel F C, Kilinç K, Büyükpamukçu N, Hiçsönmez A

机构信息

Department of Pediatric Surgery, Hacettepe University, Medical Faculty, Ankara, Turkey.

出版信息

Eur J Pediatr Surg. 1996 Oct;6(5):281-4. doi: 10.1055/s-2008-1066528.

Abstract

The mechanism of deterioration of ipsilateral and contralateral testes during unilateral maldescent remains controversial. Proposing that alterations in tissue perfusion may play a role in ipsilateral and contralateral testicular deteriorations, an experimental study has been planned to evaluate the status of parameters of tissue hypoxia in ipsilateral and contralateral testes following surgically induced maldescent, in rats which preoperatively underwent placebo or chemical sympathectomy. 60 male albino rats were used for the experiment. At the age of 21 days each 30 rats that were treated by placebo or chemical sympathectomy agent were divided into 3 groups undergoing sham operation, abdominal fixation of one testis or abdominal fixation of both testes. At the age of 3 months the rats underwent bilateral orchidectomies and lactic acid (LA) and hypoxanthine (HX) levels were measured in testicular tissues. Maldescent of the testis resulted in a marked increase of LA and HX values in the ipsilateral testis compared to controls, and also resulted in increased levels of LA and HX in the contralateral testis. Although the levels of LA and HX were lower compared to ipsilateral undescended counterparts the levels in contralateral testis were significantly elevated compared to the contralateral testes of rats undergoing sham operation following placebo treatment. Bilateral maldescent resulted in similar elevations of LA and HX in both of the testes. Administration of 6-hydroxydopamine did not result in decreased levels of LA and HX values in the ipsilateral testis following unilateral testicular undescendence. However the LA levels in the contralateral descended testis did not reveal a significant difference compared to the contralateral testis of rats undergoing sham operation. The present experimental design reveals that abdominal fixation of the testis results in tissue hypoxia not only in the ipsilateral but also in the contralateral testis. Chemical sympathectomy has some protective effects on contralateral testicular hypoxia during unilateral maldescent. Tissue hypoxia during maldescent may result from relative inadequacy of testicular blood flow to overcome the increased metabolic demands under hyperthermic conditions.

摘要

单侧睾丸未降入阴囊时同侧和对侧睾丸恶化的机制仍存在争议。鉴于组织灌注改变可能在同侧和对侧睾丸恶化中起作用,已计划开展一项实验研究,以评估在术前接受安慰剂或化学性交感神经切除术的大鼠中,手术诱导睾丸未降入阴囊后同侧和对侧睾丸组织缺氧参数的状况。60只雄性白化病大鼠用于该实验。在21日龄时,将接受安慰剂或化学性交感神经切除剂治疗的每组30只大鼠分为3组,分别接受假手术、一侧睾丸腹部固定或双侧睾丸腹部固定。在3月龄时,对大鼠进行双侧睾丸切除术,并测量睾丸组织中的乳酸(LA)和次黄嘌呤(HX)水平。与对照组相比,睾丸未降入阴囊导致同侧睾丸中LA和HX值显著升高,同时也导致对侧睾丸中LA和HX水平升高。尽管与同侧未降入阴囊的对应睾丸相比,对侧睾丸中LA和HX水平较低,但与接受安慰剂治疗后进行假手术的大鼠的对侧睾丸相比,对侧睾丸中的水平显著升高。双侧睾丸未降入阴囊导致两个睾丸中LA和HX出现类似升高。给予6-羟基多巴胺并未导致单侧睾丸未降入阴囊后同侧睾丸中LA和HX值降低。然而,与接受假手术的大鼠的对侧睾丸相比,对侧已降入阴囊的睾丸中的LA水平未显示出显著差异。本实验设计表明,睾丸腹部固定不仅会导致同侧睾丸,还会导致对侧睾丸出现组织缺氧。化学性交感神经切除术对单侧睾丸未降入阴囊期间对侧睾丸缺氧具有一定的保护作用。睾丸未降入阴囊期间的组织缺氧可能是由于在高温条件下睾丸血流相对不足,无法满足增加的代谢需求所致。

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