THE INFLUENCE OF TEMPERATURE ON CHANGES IN PH, LACTATE AND MORPHOLOGYDURING TESTICULAR ISCHEMIA

Objective To examine the role of temperature in the irreversible chang es that occur within 4-6 h as ischaemic atrophy develops in the testis during testicular torsion, by determining effects on testicular pH, l actate accumulation and morphology. Materials and methods Tissue acidi fication (pH), tissue lactate and structural changes were measured at temperatures of 35, 25, 15 and 5 degrees C in 34 human testes obtained as orchidectomy specimens from patients with metastatic prostatic can cer, and in 19 testes taken from young dogs. Results At a normal testi cular temperature of 35 degrees C, the pH decreased to 6.0 within 2 h of the onset of ischaemia; cooling to 15 degrees C extended this delay to 6 h. Tissue lactate increased from 25 mu mol/g dry weight to about 200 mu mol/g at 35 degrees C. Semi-thin sections of the canine testes showed swelling of the intratubular tissue with loss of interstitial space; lower temperatures delayed these changes. Conclusions In the pr esent study, 6 h of torsion was relatively prolonged, in that the pH d ecreased to 5.8 and testicular tissue was destroyed, Acidification and histological damage can be prevented by cooling. The critical pH of t he testis beyond which irreversible changes occur is unknown; a pH of < 6.0 is likely to provoke such changes.