Abstract:

Objective:  Testicular torsion results in damage of the gonad and represents surgical emergency. Testicular torsion induces sterility as a result of ischemia. The aim of this study was to determine the effects of a vasodilator agent sildenafil on the testicular damage following testicular torsion. Methods: Forty-two Wistar-albino male albino rats were divided into seven groups, each containing six rats. C: Control, S: Sham (operative procedure without torsion), T: Torsion (detorsion was performed 2 hours after 720° left testis torsion and orchiectomy was done at the 4th hour.),  Sildenafil (Viagra; Pfizer) was given without torsion to V1 group and V2 group (respectively 1 mg/kg and 2 mg/kg). Sildenafil was given to V1T group and V2T group respectively 1mg/kg and 2mg/kg at the first hour following torsion then detorsion was performed 2 hours after torsion and orchiectomy was done at the 4th hour.  At the end of the study blood and testes tissue samples were obtained for malonyldialdehyde  (MDA), nitric oxide (NO), Johnsen tubuler biopsy score (JTBS) and diameter of seminiferous tubule (STD) analysis. Results: JTBS and STD levels were highest in the C group and the lowest T Group and torsion reduced spermatogenesis significantly compared to the C and S groups (p<0.05). Sildenafil administration without torsion (V1 and V2) did not change JTBS scores. JTBS levels of the V2T group were increased significantly when compared to V1T (p<0,05). C compared to study groups showed statistically different changes in terms of STD (p<0,05). Torsion reduced STD significantly compared to the C and S group (p<0,05). Tissue and plazma MDA levels were the highest in the V2T group and the lowest C Group. Tissue NO levels were the highest in the V1T group and lowest in C Group. Sildenafil administration (1 mg/kg and 2 mg/kg) without torsion group compared to torsion groups in terms of plasma and testis tissue MDA and NO levels showed significantly statistically different changes. Conclusion: Sildenafil showed a protective effect against tubular damage histologicaly after unilateral torsion and detorsion. 

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