The effect of detorsion versus orchiectomy following experimental unilateral testicular torsion on the contralateral testis and epididymis: a light and transmission electron microscopic study

Introduction :Testicular torsion is a true surgical emergency that results from rotation of the testis around the axis of the spermatic cord. Aim of the study :To determine the microscopic changes in the contralateral testis and epididymis following corrective detorsion or orchiectomy. It was also aimed to determine which of the two procedures better preserves the testicular structure. Materials and methods: Young adult rats (2–3 months old) were divided into three groups. Group I included sham-operated animals. group II included animals that were subjected to left testicular torsion for 2 h. Then, they were subjected to ipsilateral detorsion, followed by a 1-week recovery period. group III included animals that were subjected to left testicular torsion for 2 h as in group II. Then, the animals were subjected to left testicular orchiectomy, followed by a 1-week recovery period. At the end of the experiment, specimens from the right testes and epididymi were taken and prepared for light and transmission electron microscopic study. Results :Group II showed distortion of the seminiferous tubules with loss of the normal architecture. The spermatogenic cells were disorganized, degenerated, and separated from the underlying basement membranes. Many multinucleated giant cells were observed in some seminiferous tubules. The lumena of some tubules contained acidophilic necrotic material and sloughed germ cells, with the absence of sperm in most of them. The interstitial spaces were wide and hypercellular. The tubules of the epididymis were filled with necrotic remnants. By electron microscopy, the spermatogenic cells appeared irregular, distorted, and their cytoplasm contained many vacuoles. Group III showed a better tubular architecture in relation to group II. Conclusion: It was concluded that orchiectomy following testicular torsion better preserved the structure of the contralateral testis and epididymis as compared with detorsion.