International Urology and Nephrology

, Volume 46, Issue 4, pp 731–736

Comparison of erythropoietin and sildenafil protective role against ischemia/reperfusion injury of the testis in adult rats

  • Nick Zavras
  • Ioannis D. Kostakis
  • Stratigoula Sakellariou
  • Christos Damaskos
  • Evangelos Roupakas
  • Eleni Tsagkari
  • Eleftherios Spartalis
  • Konstantinos Velaoras
  • Ismene A. Dontas
  • Theodore Karatzas
Urology - Original Paper



Tissue damage in testicular torsion/detorsion is caused not only by the ischemia, but also by the ischemia/reperfusion injury after detorsion. Erythropoietin and sildenafil are considered to protect against ischemia/reperfusion injury. Here, we studied and compared their actions in testicular torsion/detorsion in adult rats.


Twenty-two adult male Wistar Albino rats were divided into four groups. Rats in group A (n = 5) were sham operated. Rats in group B (n = 5), group C (n = 6) and group D (n = 6) underwent torsion of the right testis and detorsion after 90 min. No pharmaceutical intervention was performed in group B. Erythropoietin (1,000 IU/kg) and sildenafil (0.7 mg/kg) were injected intraperitoneally in groups C and D, respectively, after 60 min of torsion. All animals were killed 24 h after detorsion, and their right testis was extracted, placed into 10 % formalin solution and sent for histopathological examination. The histological changes in the testes were scored according to the four-point grading system proposed by Cosentino et al.


All rats in group A had normal testicular architecture (grade 1). The untreated group B had a mean grade of 3.81 (range 3.65–4). The treated groups C (mean grade 3.24; range 3.05–3.45) and D (2.69, range 2.4–2.9) presented statistically significant better results (lower grades) compared with the untreated group B. Group D had significantly better results (lower grades) than group C.


The intraperitoneal injection of erythropoietin and sildenafil protects against ischemia/reperfusion injury after testicular torsion and detorsion. Sildenafil may have a stronger action than erythropoietin at the doses used in this study.


Testicular torsion Ischemia/reperfusion injury Erythropoietin Sildenafil Rats 


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Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Nick Zavras
    • 1
  • Ioannis D. Kostakis
    • 2
    • 3
    • 6
  • Stratigoula Sakellariou
    • 4
  • Christos Damaskos
    • 2
    • 3
  • Evangelos Roupakas
    • 2
    • 3
  • Eleni Tsagkari
    • 2
    • 3
  • Eleftherios Spartalis
    • 2
    • 3
  • Konstantinos Velaoras
    • 5
  • Ismene A. Dontas
    • 2
  • Theodore Karatzas
    • 2
    • 3
  1. 1.Third Department of Surgery, Attikon University HospitalNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
  2. 2.Laboratory of Experimental Surgery and Surgical Research “N.S. Christeas”National and Kapodistrian University of Athens, Medical SchoolAthensGreece
  3. 3.Second Department of Propedeutic Surgery, “Laiko” General HospitalNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
  4. 4.First Department of PathologyNational and Kapodistrian University of Athens, Medical SchoolAthensGreece
  5. 5.Department of Pediatric SurgeryPenteli General Children’s HospitalAthensGreece
  6. 6.AthensGreece

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