NEOVASCULARIZATION OF THE TESTICLE THROUGH SPERMATIC VESSELS BY OMENTAL PEDICLE FLAP - A NEW EXPERIMENTAL-MODEL

The aim of this experimental study in rats was to consider the supplem entary role of an omental pedicle flap on the neovascularization of th e testicles through the spermatic vessels, for which a Fowler-Stephens procedure had been planned, To compare results, 12 animals had only t he spermatic vessels ligated, without an additional procedure (Fowler- Stephens procedure [FS group]), and 12 others had omentopexy of the sp ermatic vessels of the left testes, with ligation of the vessels 4 wee ks later (Fowler-Stephens procedure plus omentopexy [FSO group]). In t he sham group (n = 8), only omentopexy of the left spermatic vessels w as performed. Six rats served as controls. In each rat, both testes we re evaluated by color Doppler ultrasonography to assess capsular and i ntratesticular blood flow, followed by orchiectomy to determine testic ular weights, testicular biopsy scores, and mean seminiferous tubule d iameters. Data were analyzed statistically. According to the color Dop pler ultrasonography, the testicular blood flow in the FSO group was b etter than that of the FS group, but was less sufficient than that of the sham and control groups. The testicular weights and biopsy scores for the FSO group were statistically greater than those of the FS grou p, and less than those of the sham and control groups. There was no si gnificant difference in the mean seminiferous tubule diameters of the FSO and FS groups. The contralateral testes of the four groups did not differ significantly for any parameter. In light of the data availabl e, it is suggested that the omental pedicle flap neovascularizes the t esticle through spermatic vessels. Given the high incidence of testicu lar atrophy associated with Fowler-Stephens orchiopexies, it might be beneficial to perform laparoscopic orchiopexy of testicles neovascular ized with omental pedicle flaps as the first-stage procedure. (C) 1995 by W.B. Saunders Company