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The Impact of Testicular Torsion on Testicular Function

The World Journal of Men′s Health 2020년 38권 3호 p.298 ~ 307
Jacobsen Frederik M., Rudlang Trine M., Fode Mikkel, Ostergren Peter B., Sonksen Jens, Ohl Dana A., Jensen Christian Fuglesang S.,
소속 상세정보
 ( Jacobsen Frederik M. ) - University of Copenhagen Herlev and Gentofte Hospital Department of Urology
 ( Rudlang Trine M. ) - University of Copenhagen Herlev and Gentofte Hospital Department of Urology
 ( Fode Mikkel ) - University of Copenhagen Herlev and Gentofte Hospital Department of Urology
 ( Ostergren Peter B. ) - University of Copenhagen Herlev and Gentofte Hospital Department of Urology
 ( Sonksen Jens ) - University of Copenhagen Herlev and Gentofte Hospital Department of Urology
 ( Ohl Dana A. ) - University of Michigan Department of Urology
 ( Jensen Christian Fuglesang S. ) - University of Copenhagen Herlev and Gentofte Hospital Department of Urology

Abstract


Torsion of the spermatic cord is a urological emergency that must be treated with acute surgery. Possible long-term effects of torsion on testicular function are controversial. This review aims to address the impact of testicular torsion (TT) on the endocrine- and exocrine-function of the testis, including possible negative effects of torsion on the function of the contralateral testis. Testis tissue survival after TT is dependent on the degree and duration of TT. TT has been demonstrated to cause long-term decrease in sperm motility and reduce overall sperm counts. Reduced semen quality might be caused by ischemic damage and reperfusion injury. In contrast, most studies find endocrine parameters to be unaffected after torsion, although few report minor alterations in levels of gonadotropins and testosterone. Contralateral damage after unilateral TT has been suggested by histological abnormalities in the contralateral testis after orchiectomy of the torsed testis. The evidence is, however, limited as most human studies are small case-series. Theories as to what causes contralateral damage mainly derive from animal studies making it difficult to interpret the results in a human context. Large long-term follow-up studies are needed to clearly uncover changes in testicular function after TT and to determine the clinical impact of such changes.

키워드

Fertility; Infertility, male; Spermatic cord torsion; Testicular torsion; Testis; Testosterone

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