Evaluation of contralateral testicular damage after unilateral testicular torsion by serum inhibin B levels

Background/Purpose: It is still controversial whether unilateral testicular torsion (TT) affects contralateral testis. The authors wanted to evaluate contralateral testicular damage in a rat model by the serum inhibin B level s, which is suggested as a marker of Sertoli cell function and spermatogene sis. Methods: Fifty peripubertal male Wistar Albino rats were divided into 5 gro ups each containing 10 rats. Surgery was conducted under intraperitoneal 1- shot ketamine (50 mg/kg) anesthesia. Torsion-detorsion, torsion-detorsion-o rchiectomies, orchiectomies, and sham operations were performed on the righ t testicle through a midline incision. Torsions were created by rotating th e right testes 720 degrees in a clockwise direction and maintained by fixin g the testes to the scrotum with a silk suture. Torsion duration was 4 hour s. After each surgical intervention the incisions were closed. In group 1, 3-mL blood samples were taken to determine basal values of inhibin B in ser um, and bilateral orchiectomies were performed. In group 2, 4 hours of tors ion and detorsion was created and 1 month later, 3-mL blood samples were ta ken, and bilateral orchiectomies were performed. In group 3, 4 hours of tor sion-4 hours of detorsion was created, and right orchiectomies were perform ed and 1 month later, 3-mL blood samples were taken and contralateral orchi ectomies were added. In group 4, unilateral orchiectomies were per formed, and 1 month later, 3-mL blood samples were taken, and contralateral orchiec tomies were added. After the measurement of the serum inhibin B levels and histopathologic examinations, results are expressed as mean +/- SD. Results: Serum inhibin B levels expressed as mean +/- SD were 108.233 +/- 2 1.296 pg/mL for group 1, 54.065 +/- 16.910 pg/mL for group 2, 74.195 +/- 2. 779 pg/mL for group 3, 108.335 +/- 26.078 pg/mL for group 4, and 107.645 +/ - 4.705 pg/mL for group 5. Inhibin B levels in group 2 and group 3 were dif ferent from group 1, group 4, and group 5 (P < .05). In histologic examinat ion, Johnsen's scores expressed as mean C SD of right testes were 9.74 +/- 0.08 for group 1, 3.64 +/- 3.36 for group 2, and 9.86 +/- 0.05 for group 5. Histologic findings in group 2 were different from group 1 and group 5(P < .05). Johnsen's scores expressed as mean +/- SD of left testes were 9.78 /- 0.09 for group 1, 9.75 +/- 0.14 for group 2, 9.76 +/- 0.15 for group 3, 9.79 +/- 0.07 for group 4, and 9.82 +/- 0.08 for group 5, and there was no difference between groups (P > .05). Conclusions: The serum inhibin B levels decrease after unilateral TT reflec ting contralateral testicular damage. Orchiectomy to prevent contra lateral testicular damage after TT may not be effective after critical period. Mea surement of inhibin B levels to evaluate contralateral testicular damage af ter unilateral TT is more effective than histopathologic examination. Copyr ight (C) 2001 by W.B. Saunders Company.