大鼠一侧睾丸扭转对侧睾丸改变的实验研究

目的 :研究一侧睾丸扭转 (UTT)后对侧睾丸组织学及生精细胞凋亡的改变 ,以明确UTT后对侧睾丸是否存在损伤。　方法 :SD雄性大鼠 6 0只 ,随机分为实验组 (n =4 8)及对照组 (n =12 )。实验组采用Turner方法建立左侧睾丸扭转模型 ,于扭转后 6h处死 4只 ,其余 4 4只再分为扭转睾丸复位及切除组 ,分别于术后 1d、1周、4周处死7～ 8只 ,取睾丸组织进行组织学及生精细胞凋亡的检测。　结果 :UTT复位后对侧睾丸组织学发生明显改变 ,生精细胞凋亡指数明显高于对照组 (P <0 .0 5 )。扭转睾丸切除后对侧睾丸变化不明显。　结论 :UTT可引起对侧睾丸损伤 ,其机制可能与再灌注有关 ,扭转睾丸切除可防止或减轻对侧睾丸的损伤     

灯盏花素对青春前期大鼠睾丸扭转复位双侧睾丸的保护作用

目的:探讨灯盏花素青春前期大鼠睾丸扭转复位双侧睾丸的远期保护作用。方法:对建立左侧睾丸扭转复位动物模型,将32只4周龄健康SD雄性大鼠随机分为4组:假手术组、生理盐水组(腹腔内注射生理盐水2 mg/kg)、灯盏花素单次给药组(睾丸复位前30 min,腹腔缓慢注入灯盏花素2 mg/kg,给药体积为0.5 ml/100 g体重)和灯盏花素连续给药组(在单次给药组的基础上,于术后每天注射同等剂量灯盏花素注射液1次,连续7 d),每组8只。术后6周处死大鼠,取双侧睾丸和附睾,检测睾丸组织总抗氧化能力(T-AOC)、超氧化物歧化酶(SOD)、一氧化氮合酶(NOS)活性与丙二醛(MDA)含量,测定精子浓度、存活率和活动率,行睾丸组织病理学观察。结果:与同侧生理盐水组比较,两给药组双侧SOD、T-AOC、NOS活性、精子浓度、精子存活率和精子活动率均升高,MDA含量下降,其中各检测指标除单次给药组健侧T-AOC活性、精子浓度、精子活动率、双侧NOS活性及连续给药组健侧NOS活性外差异均显著(P0.05);与同侧单次给药组比较,连续给药组双侧SOD、T-AOC、NOS活性、精子浓度、精子存活率和精子活动率均升高,MDA含量下降,其中各项指标除健侧NOS活性外差异均显著(P0.05)。生理盐水组可见双侧生精小管退变,间质水肿,且患侧受损明显大于健侧;两给药组使双侧睾丸扭转复位后损伤的组织学改变明显改善。结论:灯盏花素可通过有效清除氧自由基,减轻脂质过氧化损伤,对青春前期大鼠睾丸扭转复位双侧睾丸有明显的保护作用,且连续给药明显优于单次给药。     

生脉注射液对不同周龄大鼠睾丸扭转复位后睾丸损伤影响的研究

目的:探讨生脉注射液对不同周龄大鼠睾丸扭转复位后睾丸损伤影响的差异。方法:3、6、12周龄健康雄性SD大鼠各16只,随机分成睾丸扭转复位+注射生脉注射液组(实验组)和睾丸扭转复位+注射生理盐水组(对照组),每组8只,建立睾丸扭转动物模型(左侧阴囊切开,绕精索顺时针扭转睾丸720°2h),并于手术后24h处死,测定各组大鼠睾丸组织内总抗氧化能力(T-AOC)、超氧化物歧化酶(SOD)活性与丙二醛(MDA)含量。结果:与各自对照组比较,3、6周实验组大鼠左侧睾丸组织中T-AOC、SOD活性和MDA含量均无显著性改变(P>0.05);12周实验组大鼠左侧睾丸组织中SOD、T-AOC明显升高,而MDA含量显著降低,差异均具有显著性(P<0.05)。结论:生脉注射液对睾丸扭转复位后的缺血再灌注急性损伤有保护作用,但对不同周龄大鼠的再灌注损伤保护作用不同,存在年龄相关性差异,对较大周龄大鼠的急性保护作用较为明显。     

高压氧对睾丸扭转/复位后生精细胞凋亡的作用

目的 探讨单侧睾丸扭转/复位后睾丸细胞凋亡状况和高压氧(HBO)的干预作用。方法 32只青春期 Wistar大鼠随机等分为 4组,1组为对照组,2～4组制成单侧睾丸扭转/复位模型(扭转 720°、2 h后复位),3组、4组分别于睾丸复位前和复位后立即予以 60 min HBO治疗。术后48 h获取双侧睾丸,原位缺口末端标记法(TUNEL)观察细胞凋亡,常规染色观察病理学改变。结果 与1组比较,2组扭转侧睾丸生精细胞凋亡增加(P<0.01)、病理损害明显;对侧睾丸生精细胞凋亡增加(P<0.01)。3～4组尤其是4组扭转侧睾丸生精细胞凋亡较2组明显减少(P<0.01)、病理损害减轻;对侧睾丸细胞凋亡较1组无明显变化(P>0.05)。结论 单侧睾丸扭转复位后,双侧睾丸生精细胞凋亡增加,复位前和复位后早期HBO治疗能明显减少细胞凋亡的发生。     

乙醇毒染大鼠睾丸总抗氧化能力、一氧化氮和一氧化氮合酶的变化与生殖细胞凋亡的关系

目的:探讨饮酒大鼠睾丸总抗氧化能力(T-AOC)、一氧化氮(NO)含量和一氧化氮合酶(NOS)活性的变化与生殖细胞凋亡的关系。方法:20只成年健康SD雄性大鼠随机均分为对照组和实验组,实验组和对照组分别用50%的乙醇溶液和蒸馏水按10 m l/kg每晚灌胃1次连续26 d(两个生精周期)后,用硝酸还原酶法测定睾丸组织中NO含量;用化学比色法测定其T-AOC和NOS活性;原位缺口末端标记(TUNEL)法检测生殖细胞凋亡指数(AI)的变化。结果:与对照组相比,实验组生殖细胞AI增加(P<0.01);睾丸组织T-AOC极显著下降(P<0.01),而NO含量明显上升(P<0.01)、NOS活性显著增强(P<0.01)。结论:大量饮酒能诱导生殖细胞凋亡增加,NOS活性增强导致NO的过量产生及T-AOC的显著下降是其重要原因。     

大鼠睾丸扭转复位后附睾唾液酸含量变化及意义

目的 :探讨大鼠睾丸扭转 2h和 4h复位后 2 4h附睾唾液酸含量的变化和意义。　方法 :用 2 4只雄性SD大鼠建立左侧睾丸扭转复位模型 ,分为对照组、扭转 2h组和 4h组 ,每组 8只。 5 甲基苯二酚法检测扭转侧附睾唾液酸的含量。　结果 :睾丸扭转 2h复位后 2 4h扭转侧附睾唾液酸含量 [(2 3.385± 9.2 2 0 )mg/mgprot]改变不明显 ;睾丸扭转 4h复位后 2 4h附睾唾液酸含量 [(13.72 5± 7.80 1)mg/mgprot]下降明显 (P <0 .0 5 )。　结论 :睾丸扭转 2h复位后 2 4h附睾分泌唾液酸功能不受影响 ,扭转 4h复位后 2 4h附睾分泌唾液酸功能下降 ;附睾耐受缺血再灌注损伤的时间可能较长。     

丹血通注射液对大鼠睾丸扭转复位后的保护作用

目的:研究丹血通注射液对大鼠睾丸扭转复位后缺血再灌注损伤的保护作用。方法:将32只4周龄健康SD雄性大鼠,随机分为丹血通注射液单次给药组、丹血通注射液连续给药组、生理盐水组和假手术组,每组8只。建立单侧睾丸扭转复位动物模型(720°,2 h)。于术后6周处死大鼠,计算睾丸系数,测定精子计数和精子活动率,检测睾丸组织总抗氧化能力(T-AOC)、超氧化物歧化酶(SOD)、一氧化氮合酶(NOS)活性与丙二醛(MDA)含量。结果:丹血通注射液单次给药组、连续给药组手术侧睾丸系数(0.35±0.04、0.40±0.06)比同侧生理盐水组(0.11±0.03)均显著升高(P均0.05);精子计数[(1.44±0.50)、(3.00±1.28)×109/ml]和精子活动率[(39.63±5.04)%、(76.31±3.67)%]比同侧生理盐水组[(0.46±0.10)×109/ml、(13.63±14.04)%]均显著升高(P均0.05);两给药组SOD(116.25±8.83、133.20±13.84)、T-AOC(13.34±5.81、19.21±5.69)活性和MDA含量(20.94±5.65、15.02±1.03)比同侧生理盐水组SOD(72.76±5.58)、T-AOC(5.58±1.07)活性升高和MDA含量(42.38±8.94)显著降低(P均0.05)。且连续给药组手术侧与单次给药组睾丸系数、精子计数、精子活动率、SOD、MDA、T-AOC比较差异均有显著性(P均0.05)。结论:丹血通注射液可有效清除氧自由基,通过抗氧化作用可以提高精子的活动率和数量,对青春前期大鼠睾丸缺血再灌注损伤具有明显的保护作用,对其对侧睾丸亦有一定的保护作用,且连续给药效果明显优于单次给药。     

未成熟大鼠睾丸单侧扭转后对健侧血流和组织学的影响

目的:观察未成熟大鼠睾丸单侧扭转后对健侧睾丸血流供应和组织学的影响,并比较不同处理方法的疗效。方法:建立Wistar3周龄大鼠左侧睾丸扭转模型,分别建立对照组、扭转组、扭转复位组和扭转切除组,每组10只。彩色多普勒测量各组术前、术后8h(即扭转复位或切除术后2h)、12h、24h、72h右侧睾丸动脉收缩期最大血流速度,并于对照组和扭转组术后2h,扭转复位组和扭转切除组第1次术后12h各取2只大鼠右侧睾丸进行组织病理学观察。各组喂养至9周龄时分别取右侧睾丸进行组织学观察及检测各组大鼠右侧睾丸的生精小管直径(STD)、生精上皮细胞计数(CMSE)和睾丸活检评分(TBS)。结果:①未成熟睾丸左侧扭转后,右侧睾丸的血供呈持续性增加。②扭转组、扭转复位组和扭转切除组右侧睾丸均有不同程度的间质水肿和超微结构改变。③9周龄时扭转组、扭转切除组右侧睾丸重量均较对照组显著增加(P<0.01);各组大鼠STD、CMSE、TBS均无显著性差异(P>0.05)。结论:未成熟大鼠睾丸单侧扭转后可引起对侧睾丸的血供增加和组织学改变,轻微损伤后扭转复位和睾丸切除预后效果相似。     

地塞米松对大鼠睾丸扭转复位后保护作用的研究

目的探讨地塞米松对大鼠睾丸扭转复位后的保护作用.方法24只成年健康SD雄性大鼠随机分为3组A组为睾丸扭转复位加生理盐水组,B组为睾丸扭转复位加地塞米松组,C组为对照组.建立单侧睾丸扭转复位模型.术后24h取手术侧睾丸,化学比色法测定睾丸组织的SOD、CAT、MPO活性和MDA含量,光镜观察病理学变化.结果与A组相比,B组的MDA含量和MPO活性降低(P＜0.01),SOD和CAT的活性增高(P＜0.01),睾丸被膜下白细胞浸润减少,无间质水肿.结论地塞米松可减轻大鼠睾丸扭转复位后的再灌注损伤,对睾丸有保护作用.     

一氧化氮合酶同功异构酶在大鼠睾丸中的表达和定位

目的 :了解一氧化氮 ( NO)在睾丸中的作用。方法 :运用免疫组织化学方法观察 3种一氧化氮合酶 ( NOS)同功异构酶在大鼠生后 4、7、1 4、3 0、60 d睾丸中的分布。结果 :( 1 )生后 4、7、1 4d大鼠睾丸未见 3种 NOS免疫阳性反应 ;( 2 )生后 3 0 d少数精母细胞及生后 60 d生精小管腔面精子和间质细胞呈 NOS1阳性 ;( 3 )生后 3 0 d少数精母细胞、支持细胞和管周类肌细胞呈 NOS2阳性 ,而生后 60 d NOS2阳性反应见于睾丸间质细胞、管周类肌细胞、支持细胞、极少数精母细胞和不成熟精子头部 ;( 4)生后 3 0 d睾丸内少数精母细胞和血管壁呈 NOS3阳性 ,生后 60 d NOS3阳性反应仅见于血管壁。结论 :NO可能参与精子发生、睾酮的分泌过程 ,并调节睾丸内的血流。     

Relationship between testicular size by ultrasonography and testicular function: Measurement of testicular length, width, and depth in patients with infertility

Objectives:   The relationships between simple testicular sizes, including the testicular length, width, and depth and testicular function were evaluated to determine the usefulness of measuring these simple parameters.
Methods:   The mean of right and left testicular length, width and depth were measured in 408 men with infertility (mean age, 35.9 ± 5.3 years) using ultrasonography. The ultrasonographic testicular volumes were calculated as the length x width x depth x 0.71. To evaluate the relationship between the testicular size and function, the patients were divided into seven to ten groups according to each testicular size parameter.
Results:   The mean testicular volume, length, depth, and width were 13.4 ml, 3.86 cm, 1.80 cm, and 2.59 cm, respectively. These three testicular dimensions significantly correlated with sperm density, total sperm count, total motile sperm count, serum follicle-stimulating hormone and luteinizing hormone equal to ultrasonographic testicular volume. The mean sperm density was in the oligozoospermic range in patients with a mean testicular volume below 10 ml, a mean length below 3.5 cm, a mean depth below 1.75 cm, and a mean width below 2.5 cm. The mean total sperm count was subnormal in patients with a mean testicular volume below 10 ml, a mean length below 3.5 cm, a mean depth below 1.5 cm, and a mean width below 2.25 cm.
Conclusions:   The testicular length, width, and depth measured by ultrasonography significantly correlated with the testicular function as well as the ultrasonographic testicular volume. A simple measurement of the testicular length, width, and depth is useful for evaluating the testicular function.      

Paternity in a patient with testicular seminoma and contralateral testicular intraepithelial neoplasia

A 32-year-old patient with unilateral βhCG-positive seminoma and contra-lateral testicular intraepithelial neoplasia (TIN; so-called carcinoma- in-situ ) with no metastases (clinical stage I) received one course of adjuvant carboplatin therapy. He refused further treatment of TIN in his remaining testis. His wife became pregnant by him 4 months later and delivered a healthy child at term. This case shows that patients with TIN in their remaining solitary testis are not necessarily infertile, and testes afflicted with TIN must also contain tubules that retain normal spermatogenic potential. Surveillance may be an treatment option for patients with TIN in their remaining testis in cases where there is a strong desire for paternity.     

Case report: Crossed testicular ectopia

Crossed testicular ectopia is a rare congenital anomaly in which both testes descend through a single inguinal canal. The typical presentation is that of ipsilateral inguinal hernia and contralateral cryptorchidism. This is a case report of crossed testicular ectopia in a 6-month-old male infant with depiction of herniorrhaphy and laparoscopic intraabdominal findings.     

Using shear wave elastography method to evaluate testicular compartment syndrome after testicular torsion

The measurement of compartment pressure is a direct method to objectively evaluate suspected compartment syndrome. However, to evaluate the evolving compartment syndrome, one needs to measure the pressure repeatedly, which may aggravate the damage of tissue. Despite several suggested approaches, an effective, noninvasive and sustainable method to detect testicular compartment syndrome is still lacking. In this context, using the method of shear wave elastography, we assessed the correlation between the intratesticular pressure and the testicular compartment elasticity (Emean) after testicular torsion in rabbits. It was found that a strong correlation between the intratesticular pressure and the Emean in the testicular border area (p < .001) or the central area (p = .001) was present. This result suggests that shear wave elastography is a reliable method to evaluate intratesticular pressure in rabbits, and it may have further potential clinical application in detecting testicular compartment syndrome.     

Onco‐testicular sperm extraction: testicular sperm extraction in azoospermic and very severely oligozoospermic cancer patients

An increased risk of testicular cancer in men with infertility and poor semen quality has been reported. In view of the high cure rates for testicular germ cell tumours, increasing clinical importance is being placed on the protection of fertility. High‐dose cytostatic therapy may be expected to cause long‐term infertility. Thus, the standard procedure for fertility protection is the cryopreservation of ejaculated spermatozoa or testicular tissue before therapy. Four male patients with azoospermia and two patients with very severe oligozoospermia underwent onco‐testicular sperm extraction (TESE). We attempted onco‐TESE in patients with azoospermia and very severe oligozoospermia after orchiectomy. Of the patients with testicular germ cell tumours, four had spermatozoa in their testicular tissues. Sertoli cell‐only syndrome was found in one patient, and one patient showed maturation arrest without the detection of spermatozoa. Three of six showed seminomatous germ cell tumour, two of six had nonseminomatous germ cell tumour and one patient showed no malignancy. Two patients achieved clinical pregnancy. Fertility challenges in men with cancer are the most straightforward because of the relative ease of obtaining and cryopreserving sperm. Testicular sperm extraction is a useful technique for obtaining spermatozoa before cytotoxic therapy in azoospermic and very severely oligozoospermic cancer patients.     

Age-related effects of transection of the testicular blood vessels on subsequent testicular development in the pig

Pigs of different ages were studied to assess the effect of age on the development of the testes after intra-abdominal transection of the testicular artery and vein. Transection of the testicular artery and vein at different stages of sexual development had a variable effect on the growth and differentiation of the testes. Transection performed at a young age (2 months) had no effect on the development of the testes (previous study). The animals used in this study were between 3 and 12 months (adult) at the time of surgical intervention. Their testes appeared to be more sensitive to disturbance of the main blood supply. The alternative vascular pedicle (vasal artery) was unable to adapt sufficiently to the increased physiological requirements of the testis during development in more than 50% of the animals. The results obtained from adult males indicate that intra-abdominal transection of the testicular vessels invariably has a deleterious effect on the testis.     

Recurrent torsion after previous testicular fixation

Background : Occasionally patients present with acute testicular pain having undergone a previous testicular fixation for torsion. The aim of this article is to review the literature and determine whether recurrent torsion of the testis is possible and whether the technique used at initial fixation is relevant. Methods : A literature search was performed using MEDLINE, Pre‐MEDLINE, EMBASE and CIANHL databases using the terms ‘spermatic cord torsion’ and ‘testicular torsion’ in combination with ‘treatment failure’, ‘re‐operation’ or ‘recurrence’. Results : Twenty cases of recurrent testicular torsion after fixation are described. Fifteen of the 17 that specified the type of suture used at initial fixation had used absorbable suture. Animal models suggest that to produce dense adhesions at testicular fixation, the tunica vaginalis must be everted behind the testis with or without fixation, before the testis is returned to the scrotum. Without this eversion, the adhesions around the testis are fine and only located at the site of fixation suture. The use of non‐absorbable suture led to abscess formation in 30% of testes in animal models. Conclusions : The higher incidence of recurrent torsion after fixation using absorbable rather than non‐absorbable sutures in the literature may be caused by a greater number of fixations being carried out using absorbable suture. Use of non‐absorbable suture is limited by the high rate of abscess formation. The most important factor for adhesion formation would appear to be the eversion of the tunica vaginalis and it is recommended that this is carried out at all testicular fixations.     

Relationship between testicular volume and testicular function： comparison of the Prader orchidometric and ultrasonographic measurements in patients with infertility

Aim： To evaluate the relationship between testicular function and testicular volume measured by using Prader orchidometry and ultrasonography （US） to determine the critical testicular volume indicating normal testicular function by each method. Methods： Total testicular volume （right plus left testicular volume） was measured in 794 testes in 397 men with infertility （mean age, 35.6 years） using a Prader orchidometer and also by ultrasonography. Ultrasonographic testicular volumes were calculated as length x width x height x 0.71. To evaluate volume-function relationships, patients were divided into 10 groups representing 5-mL increments of total testicular volume by each method from below 10 mL to 50 mL or more. Results： Mean total testicular volume based on Prader orchidometry and US were 36.8 mL and 26.3 mL, respectively. Semen volume, sperm density, total sperm count, total motile sperm count, and serum FSH, LH, and testosterone all correlated significantly with total testicular volume measured by either method. Mean sperm density was in the oligozoospermic range in patients with total testicular volume below 35 mL by orchidometry or below 20 mL by ultrasonography. Mean total sperm count was subnormal in patients with total testicular volume below 30 mL by orchidometry or under 20 mL by ultrasonography. Conclusion： Testicular volume measured by either ultrasonography or Prader orchidometry correlated significantly with testicular function. However, critical total testicular volume indicating normal or nearly normal testicular function was 30 mL to 35 mL using Prader orchidometer and 20 mL using ultrasonography. Prader orchidometry morphometrically and functionally overestimated the testicular volume in comparison to US. （Asian JAndro12008 Mar; 10： 319-324）     

睾丸微结石症对睾丸功能的影响分析

目的了解睾丸微结石症(TM)对睾丸功能的影响,评估TM患者精液质量和血浆性激素水平。方法生育年龄要求生殖健康体检者为对象,通过物理检查,精液分析、生殖系统超声和性激素检查评估睾丸功能,其中诊断TM患者43例,精索静脉曲张(VC)45例和健康人(NC)45例作为对照组。结果本研究TM、VC和NC3组平均年龄分别为(33.25±5.81)岁、(31.85±7.26)岁和(30.13±6.09)岁,3组年龄比较无显著性差异(P>0.05)。TM组睾丸体积、精子密度、活力、活率和血清游离睾酮水平均显著低于NC组(P<0.05),但与VC组比较无显著差异(P>0.05)。结论TM显著影响睾丸功能包括生精功能和睾酮分泌功能,其机制有待于进一步研究。     

Restricted lesions after testicular biopsies in young and adult rats

In order to evaluate the possible harmful effects of surgical removal of a testicular biopsy, adult and immature rats were subjected to unilateral testicular biopsy and were studied 24 months later. One group of adult rats were sham-operated. Perfusion-fixed, plastic-embedded specimens of the testes were examined by light microscopy. No morphological differences were found between rats that were immature and those that were adult at the time of biopsy. The lesions observed were focal and occurred only in the vicinity of the site of biopsy. Only about 0.5% (range 0.01–4.5) of the testis was affected. No morphological signs of any immune reaction were observed. It is suggested that the lesions are caused mainly by interference with local blood flow, and to a minor extent by disruption of the flow of seminiferous tubule fluid.