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Testicular torsion–detorsion and potential therapeutic treatments: A possible role for ischemic postconditioning
Author(s) -
Shimizu Shogo,
Tsounapi Panagiota,
Dimitriadis Fotios,
Higashi Youichirou,
Shimizu Takahiro,
Saito Motoaki
Publication year - 2016
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/iju.13110
Subject(s) - medicine , testicular torsion , ischemia , reperfusion injury , lipid peroxidation , spermatic cord torsion , anesthesia , surgery , oxidative stress
Abstract Testicular torsion is a common urological emergency among adolescent boys and young men. Rotation of the testis and twisting of the spermatic cord rapidly leads to ischemia, resulting in a loss of germ cells. Thus, prompt diagnosis and urgent surgical intervention are required, but the subsequent release of the torsion induces reperfusion injury, which causes further damage to the ischemic testis. Testicular torsion–detorsion (ischemia–reperfusion) injury triggers the generation of reactive oxygen species, pro‐inflammatory cytokines, neutrophil recruitment, lipid peroxidation, anoxia and apoptosis, which carry a significant risk of subsequent infertility. Previously, the effects of numerous pharmacological agents and treatments have been evaluated to prevent testicular ischemia–reperfusion injury in animal models. We propose a new treatment, especially postconditioning, to prevent adverse effects of ischemia–reperfusion injury after testicular torsion–detorsion.