Korean J Urol.  2009 Dec;50(12):1159-1167.

Twist and Shout: A Clinical and Experimental Review of Testicular Torsion

• Ellati RT
• Kavoussi P
• Turner TT
• Lysiak JJ

Abstract

PURPOSE
This review addresses different aspects of testicular torsion from the clinical perspective as well as the basic cellular and molecular events responsible for the post-torsion testicular changes and pathology, including tissue ischemia-reperfusion injury.
MATERIALS AND METHODS
A review of all published literature on testicular torsion was performed by use of two search engines.
RESULTS
Testicular torsion, or more correctly termed torsion of the spermatic cord, is a surgical emergency in order to salvage the testis. Its incidence is approximately 1 in 4,000 per annum. Testicular torsion must be treated promptly to avoid loss of the ipsilateral testis; however, even with torsion repair and gross testicular salvage, significant injury may still occur.
CONCLUSIONS
The cellular and molecular mechanisms leading to ischemia-reperfusion injury are incompletely understood, and adjuncts to surgical treatment have received little attention. Understanding the cellular and molecular effects is important because 25% of males with a history of torsion may experience adult infertility. This review emphasizes current knowledge of basic science results and clinical outcomes of testicular torsion.

Keyword

Testis; Testicular torsion; Ischemia; Reperfusion; Apoptosis

MeSH Terms

Adult
Apoptosis
Emergencies
Humans
Incidence
Infertility
Ischemia
Male
Reperfusion
Reperfusion Injury
Spermatic Cord
Spermatic Cord Torsion
Testis

Figure

• 

  Fig. 1 Semi-thin sections of perfusion-fixed rat testes stained with toluidine blue from (A) a normal testicular venule next to seminiferous tubule, (B) a testicular venule 2 hours after repair of a 1-hour torsion, and (C) a testicular venule 4 hours after repair of a 1-hour torsion. VE: vascular endothelium, PMN: marginating polymorphonuclear cells.

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