Effect of external scrotal cooling on the viability of the testis with torsion in rats

Background and Aim: Testicular damage due to ischemia during torsion is aggravated after reduction and reperfusion. The severity of the damage depends on the degree and duration of the torsion. Hypothermia has been successfully used in preserving the viability of ischemic organs for a prolonged period. Our aim is to evaluate the effect of external scrotal cooling in preserving testicular viability after spermatic cord torsion in rats. Methods: 100 adult male Sprague-Dawley rats were equally divided into ten groups. Exposure of the right testicle for either 4 or 8 h in groups 1 and 2 were the control groups. The rats in eight groups (3-10) underwent clockwise torsion of 1,080°of the right testis around its longitudinal axis, for either 4 or 8 h. External scrotal cooling was applied during the torsion period in four groups. Half of the rats were sacrificed at the end of the torsion period, while the other rats underwent detorsion and were sacrificed 2 weeks later. All testicles were excised for histology. Results: The histological results showed that external scrotal cooling decreased both immediate and late damage to the testis, caused by torsion. A moderate degree of injury was found in the contralateral testicle in rats after torsion of the right testicle for 8 h with application of external cooling and detorsion. Conclusion: External scrotal cooling is effective in preserving the viability of the torsed testis in rats. The injury of ischemia-reperfusion, although reduced by external cooling, may endanger the contralateral testis as well, if the duration of torsion is longer than 4 h. With increased duration of torsion, orchiectomy should be considered. Application of this treatment may reduce the injury in humans awaiting surgery.