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Estimating the time of onset of testicular torsion using ultrasonography in an experimental rat model

Ultrasonography 2020년 39권 2호 p.152 ~ 158
송상훈, Afsarlar Cagatay E., Xie Hui Wen, Hung Andrew J., Koh Chester J.,
소속 상세정보
송상훈 ( Song Sang-Hoon ) - University of Ulsan College of Medicine Asan Medical Center Department of Urology
 ( Afsarlar Cagatay E. ) - Hitit University Faculty of Medicine Department of Pediatric Surgery
 ( Xie Hui Wen ) - Children’s Hospital Los Angeles Division of Pediatric Urology
 ( Hung Andrew J. ) - University of Southern California Keck School of Medicine Institute of Urology
 ( Koh Chester J. ) - Texas Children’s Hospital Department of Surgery

Abstract


Purpose: We aimed to document the time of onset of ultrasonographic and histologic changes in the testes of a rat model following testicular torsion.

Methods: Twenty-five Sprague-Dawley rats were divided into four groups. All animals underwent preoperative Doppler ultrasonography. Groups 1, 2, and 3 underwent unilateral surgical torsion of the testis lasting for 72, 24, and 6 hours, respectively. Group 4 underwent a sham operation. The animals were followed with Doppler ultrasonography at 6, 24, 48, and 72 hours postoperatively. Histologic examinations were performed at the designated final time point for each group.

Results: After torsion, enlargement of the epididymal head and thickening of the spermatic cord over time were noted. Based on the ultrasonographic dimensions, the ratio of the epididymal volume increased with time following torsion (p=0.002). The torsed testes had an average weight gain of 0.27 g at 6 hours compared to the control testes, but an average weight loss of 0.22 g at 72 hours (P=0.006). Changes in testicular echotexture were noted as soon as 6 hours after torsion, but there was no consistent pattern of echotexture change thereafter. Histologically, viable tubules were seen 6 hours after torsion, while extensive hemorrhagic necrosis was found at 72 hours.

Conclusion: In evaluating testicular torsion, the enlargement ratio of the epididymis and thickening of the spermatic cord on Doppler ultrasonography may be useful for determining the urgency of immediate surgery. Changes in testicular echotexture may not be a reliable indicator of the time of onset.

키워드

Testicular torsion; Spermatic cord torsion; Ultrasonography; Testis; Epididymis

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