Is Testicular Tissue Resection Effective in Testicular Compartment Syndrome?

Abstract

Background: There have been many testicular losses due to testicular compartment syndrome (TCS). Studies are ongoing to lower the  pressure within tunica vaginalis during TCS.

Aims: To provide enough space for reperfusion of the testicular tissue and to reduce  intratesticular pressure by resecting testicular tissue in the affected testis for treatment of TCS.

Materials and Methods: The study was  designed as a prospective randomized animal study. A total of 24 Wistar albino adult rats were randomly divided into three groups. After  torsion surgery group 1 underwent detorsion + testicular tissue resection (TTR), while only detorsion was performed in group 2. The  control group did not undergo any procedures. At the postoperative 5th day all subjects were sacrificed, and their testes were evaluated  in terms of histologic findings, apoptosis, and microangiogenesis. One-way ANOVA and Tukey’s test were used for analysis.

Results:  According to Johnsen scores, all the groups were statistically different from each other and the damage in group 1 was less than in group  2 (P < 0.05). Factor VIII expressions in surgical groups were significantly higher than in the control group (P < 0.05). However, the surgical  groups did not show any significant difference between each other (P > 0.05). Apoptotic cell counts were higher in both surgical groups  than in the control group. Also, there was significantly higher apoptotic cell count in group 2 than in group 1 (P < 0.05).

Conclusions: The  injury secondary to TCS is lower when TTR is performed. In the cases in which tunica vaginalis graft could not be obtained or in the  delayed cases, TTR may be useful.