Influence of hypothermia on ischemic changes during testicular torsion

Testis torsiybnlannda surenin iskemik degisiklere olan etkisini ve bu etkinin hipotermi ile ne derecede geciktirebilecegini a(astirmak. Gereg ve Y6ntem:Or\ kopege bilateral orsiektomi uygulanarak, 20 adet torsiyone testis omegi elde edildi. Elde edilen ornekler 35°C, 20°C ve 5°C sicakliktaki ortamlarda 1 saat, 2 saat, 3 saat ve 6 saat bekletilerek histopatolojikjncelemeler icin ornekler alindi. Histopatolojik degerlendirmeler Johnsen testis biyopsi skoruna gore yapildi. Buigular: Isik mikroskobunda incelenen omeklerde 35°C'da 3 saat iginde seminifer tubulerde yer yer nekroza rastlandi. Ortalart|a Johnsen skoru 1.30±0.47 idi. Ortalama Johnsen skoru 20°C'da 3.0±0.65, 5"C'da 5.95+0.76 idi. 5°C'da 6 saat^bekletilen omeklerde seminifer tubul bazal membranlannin intakt oldugu ve spermatogonyumlarda vakuolizasyon gelistigi goruldu. Ortalama Johnsen skoru 4.95+0.76 idi. 20°C ve 35°C'da nekroz vardi. Ortalama Johnsen skoru, sirasiyla, 1.25±0.44 ve 1.20+0.41 idi. Bu saatte elde edilen omeklerde 5°C ile 20°C ve 5°C ile 35°C arasinda istatistiksel olarak anlamli fark varken, 20°C ile 35°C arasinda anlamli fark yoktu. Sonug: Akut testis torsiyonlu hastalann testislerine uygulanan hipotermi, cerrahi tedaviye alternatif degildir. Ancak testikuler canlilgi uzatarak cerrahi girisim igin zaman kazandirip or§iektomi sikligini azaltabilir.Influence of Hypothermia on Ischemic Changes During Testicular Torsion-Objective: To evaluate the effects of elapsed time and hypothermia on ischemic changes after testicular torsion. Material and Methods: Bilateral orchiectomies were done in 10 mature dogs and 20 torsioned testes were obtained. The samples were examined histopathologically after one hour, two hours, three hours and six hours of incubation in saline bath at 35°C, 20°C and 5°C. Histopathologic examinations were done with light microscopy according to Johnsen testicular score system. At a normal testicular temperature of35°C after 3 hours, necrosis was seen in some areas of seminiferous tubules. The mean Johnsen score was 1.30±0.47. At 20°C the mean Johnsen score was 3.0+0.65. At 5°C mean Johnsen score was 5.95±0.76. At a temperature of5°C and after 6 hours, basal membranes of seminiferous tubules were intact and spermatogonia showed vacuolization. The mean Johnsen score was 4.95±0.76. At 20°C and 35°C necrosis was present. The mean Johnsen scores in these groups were 1.25±0.44 and 1.20±0.41, respectively. Johnsen scores after six hours at 5°C and 20°C, and at 5°C and 35°C differed significantly while scores at 20°C and 35°C were comparable. Conclusions: Hypothermia is not an alternative to srgical exploration in-acute scrota! swelling. However, it may delay manifestations of irreversible damage, ^ prolong safe period until surgery and thus decrease orchiectomy rates