Skip to main content
SpringerLink
Log in

Oxidative Stress and Testicular Torsion

  • Chapter
  • First Online:
Book cover Studies on Men's Health and Fertility

Abstract

Testicular torsion is a medical urologic syndrome that constitutes a surgical emergency affecting newborns, children, and adolescent boys. The main pathophysiological event in testicular torsion is ischemia (torsion) followed by reperfusion (detorsion) of the testis, and multifactorial mechanisms seem to mediate this condition. Testicular damage after ischemia/reperfusion (I/R) is related to the duration of ischemia and to the severity of the torsion. I/R injury is associated with activation of neutrophils, inflammatory cytokines, and adhesion molecules with increased thrombogenicity, release of massive intracellular calcium, and overgeneration of reactive oxygen species and reactive nitrogen species. Although the results are not conclusive and the molecular mechanism by which antioxidants control male fertility have not yet been clearly identified, several antioxidant enzymes and antioxidant drugs have been studied to prevent such I/R injury in testis. Antioxidant therapy may represent a new option within a broader therapeutic strategy in testicular torsion with oxidative stress-mediated infertility.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

8-OHdG:

8-Hydroxydeoxyguanosine

AP:

Activating protein

ATP:

Adenosine triphosphate

CD:

Conjugated diene

CT:

Computed tomography

DNA:

Deoxyribonucleic acid

EFS:

Electrical field stimulation

EGF:

Epidermal growth factor

eNOS:

Endothelial nitric oxide synthase

ERK:

Extracellular signal-regulated kinase

FDA:

Food and Drug Administration

FSH:

Follicule-stimulating hormone

GSH:

Glutathione

GSH-Px:

Glutathione peroxidase

HIF:

Hypoxia-inducible factor

HSP:

Heat shock protein

I/R:

Ischemia/reperfusion

ICAM:

Intercellular adhesion molecule

IGF:

Insulin-like growth factor

IL:

Interleukin

iNOS:

Inducible nitric oxide synthase

JNK:

c-Jun-NH2-terminal kinase

l-NAME:

l-nitro arginine methyl ester

l-NMMA:

l-nitro monomethyl arginine

MAPK:

Mitogen-activated protein kinase

MDA:

Malondialdehyde

MPO:

Myeloperoxidase

MRI:

Magnetic resonance imaging

NADPH:

Nicotinamid adenine dinucleotide phosphate

NF-κB:

Nuclear factor kappa B

nNOS:

Neuronal nitric oxide synthase

NO:

Nitric oxide

PAF:

Platelet-activating factor

PARP:

Poly (adenosine triphosphate-ribose) polymerase

PPAR:

Peroxisome proliferator-activated receptor

RNA:

Ribonucleic acid

RNS:

Reactive nitrogen species

ROS:

Reactive oxygen species

SOD:

Superoxide dismutase

TBARS:

Thiobarbituric acid reactive substances

TNF:

Tumor necrosis factor

VCAM:

Vascular cellular adhesion molecule

VEGF:

Vascular endothelial growth factor

VIP:

Vasoactive intestinal polypeptide

References

  1. Heyns CF, Visser AJ. Testicular torsion. In: Schill WB, Comhaire FR, Hargreave TB, editors. Andrology for the clinician. Berlin: Springer; 2006. p. 134–61.

    Google Scholar 

  2. Rampaul MS, Hosking SW. Testicular torsion: most delay occurs outside hospital. Ann R Coll Surg Engl. 1998;80:169–72.

    PubMed  CAS  Google Scholar 

  3. Saxena AK, Höllwarth ME. Acute Scrotum. In: Puri P, Höllwarth M, editors. Pediatric surgery: diagnosis and management. Berlin: Springer; 2009. p. 927–34.

    Google Scholar 

  4. Baldisserotto M. Scrotal emergencies. Pediatr Radiol. 2009;39:516–21.

    PubMed  Google Scholar 

  5. Vigueras RM, Reyes G, Rojas-Castañeda J, et al. Testicular torsion and its effects on the spermatogenic cycle in the contralateral testis of the rat. Lab Anim. 2004;38:313–20.

    PubMed  CAS  Google Scholar 

  6. Hekimoglu A, Kurcer Z, Aral F, et al. Lycopene, an antioxidant carotenoid, attenuates testicular injury caused by ischemia/reperfusion in rats. Tohoku J Exp Med. 2009;218:141–7.

    PubMed  CAS  Google Scholar 

  7. Filho DW, Torres MA, Bordin AL, et al. Spermatic cord torsion, reactive oxygen and nitrogen species and ischemia-reperfusion injury. Mol Aspects Med. 2004;25:199–210.

    PubMed  Google Scholar 

  8. Visser AJ, Heyns CF. Testicular function after torsion of the spermatic cord. BJU Int. 2003;92:200–3.

    PubMed  CAS  Google Scholar 

  9. Sun J, Liu GH, Zhao HT, et al. Long-term influence of prepubertal testicular torsion on spermatogenesis. Urol Int. 2006;77:275–8.

    PubMed  Google Scholar 

  10. Turner TT, Bang HJ, Lysiak JJ. Experimental testicular torsion: reperfusion blood flow and subsequent testicular venous plasma testosterone concentrations. Urology. 2005;65:390–4.

    PubMed  Google Scholar 

  11. Pampal A, Ozen IO, Ekingen G, et al. The morphological evaluation of ipsilateral and contralateral vasa deferentia in a rat model of unilateral spermatic cord torsion. Pediatr Surg Int. 2010;26:287–92.

    PubMed  Google Scholar 

  12. Saba M, Morales CR, De Lamirande E, et al. Morphological and biochemical changes following acute unilateral testicular torsion in prepubertal rats. J Urol. 1997;157:1149–54.

    PubMed  CAS  Google Scholar 

  13. Savas C, Ozogul C, Karaoz E, et al. Ischemia, whether from ligation or torsion, causes ultrastructural changes on the contralateral testis. Scand J Urol Nephrol. 2002;36:302–6.

    PubMed  CAS  Google Scholar 

  14. Yao QS, Ye ZQ, Wang XK, et al. Experimental study of contralateral testicular changes after unilateral testicular torsion in rats. Zhonghua Nan Ke Xue. 2003;9:586–8.

    PubMed  Google Scholar 

  15. Pentyala S, Lee J, Yalamanchili P, et al. Testicular torsion: a review. J Low Genit Tract Dis. 2001;5:38–47.

    PubMed  CAS  Google Scholar 

  16. Ringdahl E, Teague L. Testicular torsion. Am Fam Physician. 2006;74:1739–43.

    PubMed  Google Scholar 

  17. Cosentino MJ, Nishida M, Rabinowitz R, et al. Histopathology of prepubertal rat testes subjected to various durations of spermatic cord torsion. J Androl. 1986;7:23–31.

    PubMed  CAS  Google Scholar 

  18. Dokmeci D. Testicular torsion, oxidative stress and the role of antioxidant therapy. Folia Med (Plovdiv). 2006;48:16–21.

    Google Scholar 

  19. Lysiak JJ, Nguyen QA, Turner TT. Peptide and nonpeptide reactive oxygen scavengers provide partial rescue of the testis after torsion. J Androl. 2002;23:400–9.

    PubMed  CAS  Google Scholar 

  20. Bozlu M, Acar D, Cayan S, et al. Protective effect of trapidil on long-term histologic damage in a rat model of testicular ischemia-reperfusion injury. World J Urol. 2009;27:117–22.

    PubMed  CAS  Google Scholar 

  21. Tsounapi P, Saito M, Dimitriadis F, et al. Protective effect of sivelestat, a neutrophil elastase inhibitor, on ipsilateral and contralateral testes after unilateral testicular ischaemia-reperfusion injury in rats. BJU Int. 2010;107:329–36.

    Google Scholar 

  22. Delasiauve LJF. Descente tardive du testicule gauche, prisé pour une hernie etrangleé. Rev Med Franc Etrang. 1840;1:363.

    Google Scholar 

  23. Taylor MR. A case of testicular strangulation at birth. Castration, recovery. Br Med J. 1897;1:458.

    Google Scholar 

  24. Nash W. Acute torsion of spermatic cord: reduction: immediate relief. Br Med J. 1893;1:742.

    Google Scholar 

  25. Cuckow PM, Frank JD. Torsion of the testis. BJU Int. 2000;86:349–53.

    PubMed  CAS  Google Scholar 

  26. Romero FR, Gomes RP, Lorenzini F, et al. Ipsilateral testicular necrosis and atrophy after 1,080-degree torsion of the spermatic cord in rats. Acta Cir Bras. 2009;24:118–23.

    PubMed  Google Scholar 

  27. Zampieri N, Cecchetto M, Ottolenghi A, et al. Bilateral testicular torsion: an extremely tragic rare condition. Minerva Pediatr. 2009;61:455–7.

    PubMed  CAS  Google Scholar 

  28. Bagci S, Bachour H, Woelfle JF, Mueller A, et al. Bilateral perinatal testicular torsion in an infant: a rare neonatal emergency. Pediatr Int. 2010;52:e227–8.

    PubMed  Google Scholar 

  29. Cilento BG, Atala A. Cryptorchidism, testicular torsion, and torsion of the testicular appendages. In: Kandeel FR, editor. Male reproductive dysfunction: pathophysiology and treatment. New York: Informa Healthcare; 2007. p. 165–71.

    Google Scholar 

  30. Davol P, Simmons J. Testicular torsion in a 68-year-old man. Urology. 2005;66:195.

    PubMed  Google Scholar 

  31. Kapoor S. Testicular torsion: a race against time. Int J Clin Pract. 2008;62:821–7.

    PubMed  CAS  Google Scholar 

  32. Lazarov R, Stapper G, Lock MT, et al. Testicular torsion can also be present in adult men. Ned Tijdschr Geneeskd. 2003;147:1389–93.

    PubMed  CAS  Google Scholar 

  33. Srinivasan AK, Freyle J, Gitlin JS, et al. Climatic conditions and the risk of testicular torsion in adolescent males. J Urol. 2007;178:2585–8.

    PubMed  Google Scholar 

  34. Mabogunje OA. Testicular torsion and low relative humidity in a tropical country. Br Med J (Clin Res Ed). 1986;292:363–4.

    CAS  Google Scholar 

  35. Preshaw RM. Seasonal frequency of testicular torsion. Can J Surg. 1984;27:404–5.

    PubMed  CAS  Google Scholar 

  36. Williams CR, Heaven KJ, Joseph DB. Testicular torsion: is there a seasonal predilection for occurrence? Urology. 2003;61:638–41.

    PubMed  Google Scholar 

  37. Molokwu CN, Somani BK, Goodman CM. Outcomes of scrotal exploration for acute scrotal pain suspicious of testicular torsion: a consecutive case series of 173 patients. BJU Int. 2011;107:990–3.

    PubMed  Google Scholar 

  38. Lyronis ID, Ploumis N, Vlahakis I, et al. Acute scrotum—etiology, clinical presentation and seasonal variation. Indian J Pediatr. 2009;76:407–10.

    PubMed  Google Scholar 

  39. Shukla RB, Kelly DG, Daly L, et al. Association of cold weather with testicular torsion. Br Med J (Clin Res Ed). 1982;285:1459–60.

    CAS  Google Scholar 

  40. Gatti JM, Patrick Murphy J. Current management of the acute scrotum. Semin Pediatr Surg. 2007;16:58–63.

    PubMed  Google Scholar 

  41. Marulaiah M, Gilhotra A, Moore L, et al. Testicular and paratesticular pathology in children: a 12-year histopathological review. World J Surg. 2010;34:969–74.

    PubMed  Google Scholar 

  42. Murphy FL, Law H, Mushtaq I, et al. Testicular and paratesticular pathology in infants and children: the histopathological experience of a tertiary paediatric unit over a 17 year period. Pediatr Surg Int. 2007;23:867–72.

    PubMed  CAS  Google Scholar 

  43. Mushtaq I, Fung M, Glasson MJ. Retrospective review of paediatric patients with acute scrotum. ANZ J Surg. 2003;73:55–8.

    PubMed  Google Scholar 

  44. Shteynshlyuger A, Freyle J. Familial testicular torsion in three consecutive generations of first-degree relatives. J Pediatr Urol. 2011;7:86–91.

    PubMed  Google Scholar 

  45. Okeke LI, Ikuerowo OS. Familial torsion of the testis. Int Urol Nephrol. 2006;38:641–2.

    PubMed  Google Scholar 

  46. Al-Salem AH. Intrauterine testicular torsion: a surgical emergency. J Pediatr Surg. 2007;42: 1887–91.

    PubMed  Google Scholar 

  47. Cuervo JL, Grillo A, Vecchiarelli C, et al. Perinatal testicular torsion: a unique strategy. J Pediatr Surg. 2007;42:699–703.

    PubMed  Google Scholar 

  48. Djahangirian O, Ouimet A, Saint-Vil D. Timing and surgical management of neonatal testicular torsions. J Pediatr Surg. 2010;45:1012–5.

    PubMed  Google Scholar 

  49. Eifinger F, Ahrens U, Wille S, et al. Neonatal testicular infarction—possibly due to compression of the umbilical cord? Urology. 2010;75:1482–4.

    PubMed  Google Scholar 

  50. Hutson JM. Testicular torsion. In: Grosfeld JL, O’Neill JA, Coran AG, Fonkalsrud EW, editors. Pediatric surgery. 6th ed. Philadelphia: Mosby Elsevier; 2006. p. 1205–7.

    Google Scholar 

  51. Jung YJ, Chung JM. Testicular torsion in the inguinal region in an extremely low birth weight infant. Korean J Pediatr. 2010;53:852–4.

    PubMed  Google Scholar 

  52. Kyriazis ID, Dimopoulos J, Sakellaris G, et al. Extravaginal testicular torsion: a clinical entity with unspecified surgical anatomy. Int Braz J Urol. 2008;34:617–23.

    PubMed  Google Scholar 

  53. Wan J, Bloom DA. Male genital tract. In: Oldham KT, Colombani PM, Foglia RP, Skinner MA, editors. Principles and practice of pediatric surgery. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 1602–3.

    Google Scholar 

  54. Kessler CS, Bauml J. Non-traumatic urologic emergencies in men: a clinical review. West J Emerg Med. 2009;10:281–7.

    PubMed  Google Scholar 

  55. Cimador M, DiPace MR, Castagnetti M, et al. Predictors of testicular viability in testicular torsion. J Pediatr Urol. 2007;3:387–90.

    PubMed  Google Scholar 

  56. Moon C, Shin T. Involvement of macrophages in germ cell death in the rat testis with acute experimental testicular torsion. Korean J Vet Res. 2004;44:329–34.

    Google Scholar 

  57. Arap MA, Vicentini FC, Cocuzza M, et al. Late hormonal levels, semen parameters, and presence of antisperm antibodies in patients treated for testicular torsion. J Androl. 2007;28:528–32.

    PubMed  CAS  Google Scholar 

  58. Fu GB, Qian LX, Cui YG, et al. Antisperm-antibodies induced by testicular torsion and its influence on testicular function. Zhonghua Nan Ke Xue. 2006;12:988–91.

    PubMed  CAS  Google Scholar 

  59. Koşar A, Küpeli B, Alçigir G, et al. Immunologic aspect of testicular torsion: detection of antisperm antibodies in contralateral testicle. Eur Urol. 1999;36:640–4.

    PubMed  Google Scholar 

  60. Rybkiewicz M. Long-term and late results of treatment in patients with a history of testicular torsion. Ann Acad Med Stetin. 2001;47:61–75.

    PubMed  CAS  Google Scholar 

  61. Beni-Israel T, Goldman M, Bar Chaim S, et al. Clinical predictors for testicular torsion as seen in the pediatric ED. Am J Emerg Med. 2010;28:786–9.

    PubMed  Google Scholar 

  62. Shehzad KN, Riaz AA. Unusual cause of a painful right testicle in a 16-year-old man: a case report. J Med Case Reports. 2011;5:27.

    PubMed  Google Scholar 

  63. Wiener SL. Testicular pain. In: Walker HK, Hall WD, Hurst JW, editors. Clinical methods: the history, physical, and laboratory examinations. 3rd ed. Boston: Butterworths; 1990. p. 853–6.

    Google Scholar 

  64. Chan JL, Knoll JM, Depowski PL, et al. Mesorchial testicular torsion: case report and a review of the literature. Urology. 2009;73:83–6.

    PubMed  Google Scholar 

  65. Schmitz D, Safranek S. Clinical inquiries. How useful is a physical exam in diagnosing testicular torsion? J Fam Pract. 2009;58:433–4.

    PubMed  Google Scholar 

  66. Somani BK, Watson G, Townell N. Testicular torsion. BMJ. 2010;341:c3213. doi:10.1136/bmj.c3213.

    PubMed  Google Scholar 

  67. Baker LA, Sigman D, Mathews RI, et al. An analysis of clinical outcomes using color Doppler testicular ultrasound for testicular torsion. Pediatrics. 2000;105:604–7.

    PubMed  CAS  Google Scholar 

  68. Dudea SM, Ciurea A, Chiorean A, et al. Doppler applications in testicular and scrotal disease. Med Ultrason. 2010;12:43–51.

    PubMed  Google Scholar 

  69. Ahmed SJ, Kaplan GW, DeCambre ME. Perinatal testicular torsion: preoperative radiological findings and the argument for urgent surgical exploration. J Pediatr Surg. 2008;43:1563–5.

    PubMed  Google Scholar 

  70. Chmelnik M, Schenk JP, Hinz U, et al. Testicular torsion: sonomorphological appearance as a predictor for testicular viability and outcome in neonates and children. Pediatr Surg Int. 2010;26:281–6.

    PubMed  Google Scholar 

  71. Kwon JW, Kim WS, Cheon JE, et al. Evaluation of testicular viability by power Doppler ultrasonography in experimentally induced acute testicular torsion. Invest Radiol. 2005;40:682–7.

    PubMed  Google Scholar 

  72. Mernagh JR, Caco C, De Maria J. Testicular torsion revisited. Curr Probl Diagn Radiol. 2004;33:60–73.

    PubMed  Google Scholar 

  73. Prando D. Torsion of the spermatic cord: the main gray-scale and Doppler sonographic signs. Abdom Imaging. 2009;34:648–61.

    PubMed  Google Scholar 

  74. Waldert M, Klatte T, Schmidbauer J, et al. Color Doppler sonography reliably identifies testicular torsion in boys. Urology. 2010;75:1170–4.

    PubMed  Google Scholar 

  75. Gotto GT, Chang SD, Nigro MK. MRI in the diagnosis of incomplete testicular torsion. Br J Radiol. 2010;83:e105–7.

    PubMed  CAS  Google Scholar 

  76. Terai A, Yoshimura K, Ichioka K, et al. Dynamic contrast-enhanced subtraction magnetic resonance imaging in diagnostics of testicular torsion. Urology. 2006;67:1278–82.

    PubMed  Google Scholar 

  77. Watanabe Y, Nagayama M, Okumura A, et al. MR imaging of testicular torsion: features of testicular hemorrhagic necrosis and clinical outcomes. J Magn Reson Imaging. 2007;26:100–8.

    PubMed  Google Scholar 

  78. Amini B, Patel CB, Lewin MR, et al. Diagnostic nuclear medicine in the ED. Am J Emerg Med. 2011;29:91–101.

    PubMed  Google Scholar 

  79. Ovali GY, Yilmaz O, Tarhan S, et al. Perfusion CT evaluation in experimentally induced testicular torsion. Can Urol Assoc J. 2009;3:383–6.

    PubMed  Google Scholar 

  80. Capraro GA, Coughlin BF, Mader TJ, et al. Testicular cooling associated with testicular torsion and its detection by infrared thermography: an experimental study in sheep. J Urol. 2008;180:2688–93.

    PubMed  Google Scholar 

  81. Capraro GA, Mader TJ, Coughlin BF, et al. Feasibility of using near-infrared spectroscopy to diagnose testicular torsion: an experimental study in sheep. Ann Emerg Med. 2007;49:520–5.

    PubMed  Google Scholar 

  82. Kram HB, Miyamoto E, Rajfer J, et al. Testicular oximetry: a new method for the assessment of tissue perfusion and viability following torsion and detorsion. J Pediatr Surg. 1989;24:1297–302.

    PubMed  CAS  Google Scholar 

  83. Mirilas P, Kontis E, Mentessidou A, et al. Testis rigidity tester: a prototype device for intraoperative detection of changes in testicular pressure and/or elasticity.First experimental experiences. J Pediatr Urol. 2010;6:277–81.

    PubMed  Google Scholar 

  84. Yamis S, Gedik A, Sahin H, et al. Is procalcitonin valuable in the differential diagnosis of testicular torsion and epididymo-orchitis. Saudi Med J. 2010;31:170–4.

    PubMed  Google Scholar 

  85. Kutlu O, Mentese A, Turkmen S, et al. Investigation of the possibility of using ischemia-modified albumin in testicular torsion: an experimental study. Fertil Steril. 2011;95(4):1333–7.

    PubMed  CAS  Google Scholar 

  86. Kubini K, Zachmann M, Albers N, et al. Basal inhibin B and the testosterone response to human chorionic gonadotropin correlate in prepubertal boys. J Clin Endocrinol Metab. 2000;85:134–8.

    PubMed  CAS  Google Scholar 

  87. Taskinen S, Taskinen M, Rintala R. Testicular torsion: orchidectomy or orchiopexy? J Pediatr Urol. 2008;4:210–3.

    PubMed  Google Scholar 

  88. Ozkan KU, Küçükaydin M, Muhtaroğlu S, et al. Evaluation of contralateral testicular damage after unilateral testicular torsion by serum inhibin B levels. J Pediatr Surg. 2001;36:1050–3.

    PubMed  CAS  Google Scholar 

  89. Moore CP, Marr JK, Huang CJ. Cryptorchid testicular torsion. Pediatr Emerg Care. 2011;27:121–3.

    PubMed  Google Scholar 

  90. Phuwapraisirisan S, Lim M, Suwanthanma W. Surgical reduction in a delayed case of traumatic testicular dislocation. J Med Assoc Thai. 2010;93:1317–20.

    PubMed  Google Scholar 

  91. Van der Poel J. Strangulation of the testis and epididymis from torsion of the spermatic cord. Med Rec. 1895;47:737.

    Google Scholar 

  92. Bah OR, Roupret M, Guirassy S, et al. Clinical aspects and management of the torsion of the spermatic cord: study of 27 cases. Prog Urol. 2010;20:527–31.

    PubMed  CAS  Google Scholar 

  93. Bhagra A, Suravaram S, Schears RM. Testicular torsion—a common surgical emergency. Int J Emerg Med. 2008;1:147.

    PubMed  Google Scholar 

  94. Cavusoglu YH, Karaman A, Karaman I, et al. Acute scrotum—etiology and management. Indian J Pediatr. 2005;72:201–3.

    PubMed  Google Scholar 

  95. Guerra LA, Wiesenthal J, Pike J, et al. Management of neonatal testicular torsion: which way to turn? Can Urol Assoc J. 2008;2:376–9.

    PubMed  Google Scholar 

  96. Soccorso G, Ninan GK, Rajimwale A, et al. Acute scrotum: is scrotal exploration the best management? Eur J Pediatr Surg. 2010;20:312–5.

    PubMed  CAS  Google Scholar 

  97. Anderson MJ, Dunn JK, Lipshultz LI, et al. Semen quality and endocrine parameters after acute testicular torsion. J Urol. 1992;147:1545–50.

    PubMed  CAS  Google Scholar 

  98. Ichikawa T, Kitagawa N, Shiseki Y, et al. Testicular function after spermatic cord torsion. Hinyokika Kiyo. 1993;39:243–8.

    PubMed  CAS  Google Scholar 

  99. Shafik A, El-Sibal O, Shafik I. Electro-orchidogram: a non-invasive diagnostic tool in testicular pathologies. Med Sci Monit. 2006;12:MT51–5.

    PubMed  Google Scholar 

  100. Baker BW, Surratt JK, Run W. Missed testicular torsion presenting with male infertility and erectile dysfunction. Zhonghua Nan Ke Xue. 2005;11:615–6.

    PubMed  Google Scholar 

  101. Tryfonas G, Violaki A, Tsikopoulos G, et al. Late postoperative results in males treated for testicular torsion during childhood. J Pediatr Surg. 1994;29:553–6.

    PubMed  CAS  Google Scholar 

  102. Chen HT, Zheng XM, Yang ZW, et al. Effects of hypothermia on antioxidant capacity of rat testes after testicular torsion. Zhonghua Nan Ke Xue. 2005;11:426–7.

    PubMed  CAS  Google Scholar 

  103. Gao DJ, Xuan XJ, Wang YJ, et al. Verapamil and hypothermia protect spermatogenesis of torsioned testes in rats. Zhonghua Nan Ke Xue. 2009;15:796–800.

    PubMed  CAS  Google Scholar 

  104. Haj M, Shasha SM, Loberant N, et al. Effect of external scrotal cooling on the viability of the testis with torsion in rats. Eur Surg Res. 2007;39:160–9.

    PubMed  CAS  Google Scholar 

  105. Power RE, Scanlon R, Kay EW, et al. Long-term protective effects of hypothermia on reperfusion injury post-testicular torsion. Scand J Urol Nephrol. 2003;37:456–60.

    PubMed  Google Scholar 

  106. Qian HJ, Du XJ, Zhang C, et al. Cold ischemia time influences spermatogenesis in a testicular ischemia/reperfusion injury model. Transplant Proc. 2010;42:1610–3.

    PubMed  CAS  Google Scholar 

  107. Sarica K, Bakir K. Semiquantitative evaluation of testicular histology after testicular torsion: protective effect of external cooling. Urol Int. 1999;63:110–4.

    PubMed  CAS  Google Scholar 

  108. Akçora B, Altuğ ME, Balci A, et al. Gradual detorsion of torsioned rat testis attenuates ischemia reperfusion injury. J Pediatr Surg. 2008;43:1879–84.

    PubMed  Google Scholar 

  109. Duru FI, Olabiyi O, Noronha CC, et al. Brief ischaemia reduces testicular lipid peroxidation following subsequent ischaemia: an evidence for ischaemic preconditioning. Nig Q J Hosp Med. 2008;18:149–52.

    PubMed  CAS  Google Scholar 

  110. Ozkisacik S, Yazici M, Gursoy H, et al. The effects of short-interval postconditioning in preventing testicular ischemia-reperfusion injury in rats. J Pediatr Surg. 2011;46:546–50.

    PubMed  Google Scholar 

  111. Sahinkanat T, Ozkan KU, Tolun FI, et al. The protective effect of ischemic preconditioning on rat testis. Reprod Biol Endocrinol. 2007;5:47.

    PubMed  Google Scholar 

  112. Shimizu S, Saito M, Dimitriadis F, et al. Protective effect of ischaemic post-conditioning on ipsilateral and contralateral testes after unilateral testicular ischaemia-reperfusion injury. Int J Androl. 2011;34(3):268–75. doi:10.1111/j.1365-2605.2010.01077.x.

    PubMed  CAS  Google Scholar 

  113. Shimizu S, Saito M, Kinoshita Y, et al. Ischemic preconditioning and post-conditioning to decrease testicular torsion-detorsion injury. J Urol. 2009;182:1637–43.

    PubMed  CAS  Google Scholar 

  114. Taneli F, Aydede H, Vatansever S, et al. The long-term effect of mesh bioprosthesis in inguinal hernia repair on testicular nitric oxide metabolism and apoptosis in rat testis. Cell Biochem Funct. 2005;23:213–20.

    PubMed  CAS  Google Scholar 

  115. Woodruff DY, Horwitz G, Weigel J, et al. Fertility preservation following torsion and severe ischemic injury of a solitary testis. Fertil Steril. 2010;94:352.

    PubMed  Google Scholar 

  116. Henkel RR. Leukocytes and oxidative stress: dilemma for sperm function and male fertility. Asian J Androl. 2011;13:43–52.

    PubMed  CAS  Google Scholar 

  117. Prillaman HM, Turner TT. Rescue of testicular function after acute experimental torsion. J Urol. 1997;157:340–5.

    PubMed  CAS  Google Scholar 

  118. Sharma R, Agarwal A. Role of reactive oxygen species in gynecologic diseases. Reprod Med Biol. 2004;3:177–99.

    CAS  Google Scholar 

  119. Karagüzel G, Güngör F, Karagüzel G, et al. Unilateral spermatic cord torsion without ipsilateral spermatogenetic material: effects on testicular blood flow and fertility potential. Urol Res. 2004;32:51–4.

    PubMed  Google Scholar 

  120. Otçu S, Durakoğugil M, Orer HS, et al. Contralateral genitofemoral sympathetic nerve discharge increases following ipsilateral testicular torsion. Urol Res. 2002;30:324–8.

    PubMed  Google Scholar 

  121. Romeo C, Impellizzeri P, Arrigo T, et al. Late hormonal function after testicular torsion. J Pediatr Surg. 2010;45:411–3.

    PubMed  Google Scholar 

  122. Shiraishi K, Naito K, Yoshida K. Nitric oxide promotes germ cell necrosis in the delayed phase after experimental testicular torsion of rat. Biol Reprod. 2001;65:514–21.

    PubMed  CAS  Google Scholar 

  123. Ahmed A, Bello A, Mbibu NH, et al. Epidemiological and aetiological factors of male infertility in northern Nigeria. Niger J Clin Pract. 2010;13:205–9.

    PubMed  CAS  Google Scholar 

  124. Sarkar O, Bahrainwala J, Chandrasekaran S, et al. Impact of inflammation on male fertility. Front Biosci (Elite Ed). 2011;3:89–95.

    Google Scholar 

  125. Cuzzocrea S, Riley DP, Caputi AP, et al. Antioxidant therapy: a new pharmacological approach in shock, inflammation, and ischemia/reperfusion injury. Pharmacol Rev. 2001;53:135–59.

    PubMed  CAS  Google Scholar 

  126. Antonuccio P, Minutoli L, Romeo C, et al. Lipid peroxidation activates mitogen-activated protein kinases in testicular ischemia-reperfusion injury. J Urol. 2006;176:1666–72.

    PubMed  CAS  Google Scholar 

  127. Payabvash S, Kiumehr S, Tavangar SM, et al. Ethyl pyruvate reduces germ cell-specific apoptosis and oxidative stress in rat model of testicular torsion/detorsion. J Pediatr Surg. 2008;43:705–12.

    PubMed  Google Scholar 

  128. Minutoli L, Antonuccio P, Polito F, et al. Mitogen-activated protein kinase 3/mitogen-activated protein kinase 1 activates apoptosis during testicular ischemia-reperfusion injury in a nuclear factor-kappaB-independent manner. Eur J Pharmacol. 2009;604:27–35.

    PubMed  CAS  Google Scholar 

  129. Agarwal A, Saleh RA. Role of oxidants in male infertility: rationale, significance, and treatment. Urol Clin North Am. 2002;29:817–27.

    PubMed  Google Scholar 

  130. Kehinde EO, Mojiminiyi OA, Mahmoud AH, et al. The significance of measuring the time course of serum malondialdehyde concentration in patients with torsion of the testis. J Urol. 2003;169:2177–80.

    PubMed  CAS  Google Scholar 

  131. Ahmed FA, Jequier AM, Cummins JM, et al. Differentially expressed DNA sequences following recovery from unilateral testicular torsion in rat. Biochim Biophys Acta. 2001;1535:192–9.

    PubMed  CAS  Google Scholar 

  132. Ahmed FA, Whelan J, Jequier AM, et al. Torsion-induced injury in rat testes does not affect mitochondrial respiration or the accumulation of mitochondrial mutations. Int J Androl. 2000;23:347–56.

    PubMed  CAS  Google Scholar 

  133. Andiran F, Okur DH, Kilinç A, et al. Do experimentally induced ipsilateral testicular torsion, vas deferens obstruction, intra-abdominal testis or venous obstruction damage the contralateral testis through a common mechanism? BJU Int. 2000;85:330–5.

    PubMed  CAS  Google Scholar 

  134. Heindel RM, Pakyz RE, Reinking LN, et al. The effect of various degrees of unilateral spermatic cord torsion on fertility in the rat. J Urol. 1990;144:366–9.

    PubMed  CAS  Google Scholar 

  135. Kamada K, Takihara H, Shirataki S, et al. Flow cytometric DNA analysis demonstrates contralateral testicular deterioration in experimental unilateral testicular torsion of prepubertal rats. Andrologia. 1993;25:239–44.

    PubMed  CAS  Google Scholar 

  136. Nguyen L, Lievano G, Ghosh L, et al. Effect of unilateral testicular torsion on blood flow and histology of contralateral testes. J Pediatr Surg. 1999;34:680–3.

    PubMed  CAS  Google Scholar 

  137. Baker LA, Turner TT. Leydig cell function after experimental testicular torsion despite loss of spermatogenesis. J Androl. 1995;16:12–7.

    PubMed  CAS  Google Scholar 

  138. Yang C, Song B, Tan J, et al. Testicular torsion in children: a 20-year retrospective study in a single institution. Sci World J. 2011;11:362–8.

    Google Scholar 

  139. Turner TT, Bang HJ, Lysiak JL. The molecular pathology of experimental testicular torsion suggests adjunct therapy to surgical repair. J Urol. 2004;172:2574–8.

    PubMed  CAS  Google Scholar 

  140. Guimarães SB, Santos JM, Aragão AA, et al. Protective effect of alpha-lipoic acid in experimental spermatic cord torsion. Nutrition. 2007;23:76–80.

    PubMed  Google Scholar 

  141. Said TM, Agarwal A, Sharma RK, et al. Human sperm superoxide anion generation and correlation with semen quality in patients with male infertility. Fertil Steril. 2004;82:871–7.

    PubMed  CAS  Google Scholar 

  142. Agarwal A, Said TM. Oxidative stress, DNA damage and apoptosis in male infertility: a clinical approach. BJU Int. 2005;95:503–7.

    PubMed  CAS  Google Scholar 

  143. Kothari S, Thompson A, Agarwal A, et al. Free radicals: their beneficial and detrimental effects on sperm function. Indian J Exp Biol. 2010;48:425–35.

    PubMed  CAS  Google Scholar 

  144. Saleh A, Agarwal A. Oxidative stress and male infertility: from research bench to clinical practice. J Androl. 2002;23:737–52.

    PubMed  CAS  Google Scholar 

  145. Aitken RJ, Baker MA, De Iuliis GN, et al. New insights into sperm physiology and pathology. Handb Exp Pharmacol. 2010;198:99–115.

    PubMed  CAS  Google Scholar 

  146. Dokmeci D. Oxidative stress, male infertility and the role of carnitines. Folia Med (Plovdiv). 2005;47:26–30.

    Google Scholar 

  147. Akgür FM, Kilinç K, Aktuğ T. Is ipsilateral testis mandatory for the occurrence of contralateral intratesticular biochemical changes indicative of hypoxia after unilateral spermatic cord torsion? Eur Urol. 1995;28:143–6.

    PubMed  Google Scholar 

  148. Anderson JB, Williamson RC. Fertility after torsion of the spermatic cord. Br J Urol. 1990;65:225–30.

    PubMed  CAS  Google Scholar 

  149. Becker Jr EJ, Turner TT. Endocrine and exocrine effects of testicular torsion in the prepubertal and adult rat. J Androl. 1995;16:342–51.

    PubMed  CAS  Google Scholar 

  150. Turner TT. Acute experimental testicular torsion. No effect on the contralateral testis. J Androl. 1985;6:65–72.

    PubMed  CAS  Google Scholar 

  151. Cosentino MJ, Rabinowitz R, Valvo JR, et al. The effect of prepubertal spermatic cord torsion on subsequent fertility in rats. J Androl. 1984;5:93–8.

    PubMed  CAS  Google Scholar 

  152. Tanyel FC, Büyükpamukçu N, Hiçsönmez A. Contralateral testicular blood flow during unilateral testicular torsion. Br J Urol. 1989;63:522–4.

    PubMed  CAS  Google Scholar 

  153. Thomas WE, Cooper MJ, Crane GA, et al. Testicular exocrine malfunction after torsion. Lancet. 1984;2:1357–60.

    PubMed  CAS  Google Scholar 

  154. Agarwal A, Nallella K, Allamaneni S, et al. Role of antioxidants in treatment of male infertility: an overview of the literature. Reprod Biomed Online. 2004;8:616–27.

    PubMed  CAS  Google Scholar 

  155. Agarwal A, Sekhon LH. The role of antioxidant therapy in the treatment of male infertility. Hum Fertil (Camb). 2010;13:217–25.

    Google Scholar 

  156. Kim YH, Kim GH, Shin JH, et al. Effect of korean red ginseng on testicular tissue injury after torsion and detorsion. Korean J Urol. 2010;51:794–9.

    PubMed  Google Scholar 

  157. Erol B, Bozlu M, Hanci V, et al. Coenzyme Q10 treatment reduces lipid peroxidation, inducible and endothelial nitric oxide synthases, and germ cell-specific apoptosis in a rat model of testicular ischemia/reperfusion injury. Fertil Steril. 2010;93:280–2.

    PubMed  CAS  Google Scholar 

  158. Aktoz T, Kanter M, Aktas C. Protective effects of quercetin on testicular torsion/­detorsion-induced ischaemia-reperfusion injury in rats. Andrologia. 2010;42:376–83.

    PubMed  CAS  Google Scholar 

  159. Ozturk H, Ozturk H, Gideroglu K, et al. Montelukast protects against testes ischemia/reperfusion injury in rats. Can Urol Assoc J. 2010;4:174–9.

    PubMed  Google Scholar 

  160. Shirazi M, Noorafshan A, Karbalay-Doust S, et al. Comparison of the protective effects of papaverine, lidocaine and verapamil on the sperm quality of the testis after induced torsion-detorsion in rats. Scand J Urol Nephrol. 2010;44:133–7.

    PubMed  CAS  Google Scholar 

  161. Yang S, Shih HJ, Chow YC, et al. Simvastatin attenuates testicular injury induced by torsion-detorsion. J Urol. 2010;184:750–6.

    PubMed  CAS  Google Scholar 

  162. Said TM, Paasch U, Glander HJ, et al. Role of caspases in male infertility. Hum Reprod Update. 2004;10:39–51.

    PubMed  CAS  Google Scholar 

  163. Bozlu M, Coşkun B, Cayan S, et al. Inhibition of poly(adenosine diphosphate-ribose) polymerase decreases long-term histologic damage in testicular ischemia-reperfusion injury. Urology. 2004;63:791–5.

    PubMed  Google Scholar 

  164. Bozlu M, Eskandari G, Cayan S, et al. The effect of poly (adenosine diphosphate-ribose) polymerase inhibitors on biochemical changes in testicular ischemia-reperfusion injury. J Urol. 2003;169:1870–3.

    PubMed  CAS  Google Scholar 

  165. Hekimoglu A, Kurcer Z, Aral F, et al. Effects of 3-aminobenzamide on unilateral testicular ischemia-reperfusion injury: what is the role of PARP inhibition? Can J Physiol Pharmacol. 2010;88:1123–9.

    PubMed  CAS  Google Scholar 

  166. Kar A, Ozden E, Yakupoglu YK, et al. Experimental unilateral spermatic cord torsion: the effect of polypolymerase enzyme inhibitor on histopathological and biochemical changes in the early and late periods in the ipsilateral and contralateral testicles. Urology. 2010;76:507.e1–5.

    Google Scholar 

  167. Moon C, Yasuzumi F, Okura N, et al. Enhanced expression of tyrosine kinase receptor a in germ cells of rat testis with acute experimental testicular torsion. Urol Int. 2005;74:79–85.

    PubMed  CAS  Google Scholar 

  168. Minutoli L, Antonuccio P, Polito F, et al. Involvement of mitogen-activated protein kinases (MAPKs) during testicular ischemia-reperfusion injury in nuclear factor-kappaB knock-out mice. Life Sci. 2007;81:413–22.

    PubMed  CAS  Google Scholar 

  169. Minutoli L, Antonuccio P, Romeo C, et al. Evidence for a role of mitogen-activated protein kinase 3/mitogen-activated protein kinase in the development of testicular ischemia-reperfusion injury. Biol Reprod. 2005;73:730–6.

    PubMed  CAS  Google Scholar 

  170. Moon C, Kim JS, Jang H, et al. Activation of Akt/protein kinase B and extracellular signal-regulated kinase in rats with acute experimental testicular torsion. J Vet Med Sci. 2008;70:337–41.

    PubMed  CAS  Google Scholar 

  171. Powell JD, Elshtein R, Forest DJ, et al. Stimulation of hypoxia-inducible factor-1 alpha (HIF-1alpha) protein in the adult rat testis following ischemic injury occurs without an increase in HIF-1alpha messenger RNA expression. Biol Reprod. 2002;67:995–1002.

    PubMed  CAS  Google Scholar 

  172. Al-Maghrebi M, Kehinde EO, Anim JT. Long term testicular ischemia-reperfusion injury-induced apoptosis: involvement of survivin down-regulation. Biochem Biophys Res Commun. 2010;395:342–7.

    PubMed  CAS  Google Scholar 

  173. Erol B, Tokgoz H, Hanci V, et al. Vardenafil reduces testicular damage following ischemia/reperfusion injury in rats. Kaohsiung J Med Sci. 2009;25:374–80.

    PubMed  CAS  Google Scholar 

  174. Beheshtian A, Salmasi AH, Payabvash S, et al. Protective effects of sildenafil administration on testicular torsion/detorsion damage in rats. World J Urol. 2008;26:197–202.

    PubMed  CAS  Google Scholar 

  175. Yildiz H, Durmus AS, Simşek H, et al. Protective effect of sildenafil citrate on contralateral testis injury after unilateral testicular torsion/detorsion. Clinics (Sao Paulo). 2011;66:137–42.

    Google Scholar 

  176. Istanbulluoglu MO, Zor M, Celik A, et al. Effects of vardenafil on testicular torsion/detorsion damage: an experimental study in pigs. Urol Int. 2011;86:228–32.

    PubMed  CAS  Google Scholar 

  177. Ustün H, Akgül KT, Ayyildiz A, et al. Effect of phosphodiesterase 5 inhibitors on apoptosis and nitric oxide synthases in testis torsion: an experimental study. Pediatr Surg Int. 2008;24:205–11.

    PubMed  Google Scholar 

  178. Köseoğlu B, Yilmaz E, Ceylan K, et al. The protective effect of erythropoietin infusion on testicular torsion/detorsion: an experimental study. Int Urol Nephrol. 2009;41:85–91.

    PubMed  Google Scholar 

  179. Uguralp S, Bay Karabulut A, Mizrak B, et al. The effect of sustained and local administration of epidermal growth factor on improving bilateral testicular tissue after torsion. Urol Res. 2004;32:323–31.

    PubMed  CAS  Google Scholar 

  180. Hashimoto H, Ishikawa T, Yamaguchi K, et al. Experimental ischaemia-reperfusion injury induces vascular endothelial growth factor expression in the rat testis. Andrologia. 2009;41:216–21.

    PubMed  CAS  Google Scholar 

  181. Tunçkiran A, Cayan S, Bozlu M, et al. Protective effect of vascular endothelial growth factor on histologic changes in testicular ischemia-reperfusion injury. Fertil Steril. 2005;84:468–73.

    PubMed  Google Scholar 

  182. Savas C, Ozguner IF, Ozguner M, et al. The effects of unilateral testicular ischemia and hemicastration on contralateral testicular IGF-1 level, histology and lipid peroxidation. Int Urol Nephrol. 2003;35:231–5.

    PubMed  CAS  Google Scholar 

  183. Ozkurkcugil C, Yardimoglu M, Dalcik H, et al. Effect of insulin-like growth factor-1 on apoptosis of rat testicular germ cells induced by testicular torsion. BJU Int. 2004;93:1094–7.

    PubMed  CAS  Google Scholar 

  184. Zhao YG, Zheng XM, Zhou J, et al. Changes of nuclear factor-kappa gene binding expression in and apoptosis of spermatogenic epithelial cells in the restored testis after torsion: experiment with rats. Zhonghua Yi Xue Za Zhi. 2006;86:1381–5.

    PubMed  CAS  Google Scholar 

  185. Zhao YG, Zheng XM, Zhou J, et al. Sulfasalazine prevents apoptosis in spermatogenic cells after experimental testicular torsion/detorsion. Acta Pharmacol Sin. 2006;27:603–8.

    PubMed  CAS  Google Scholar 

  186. Lysiak JJ. The role of tumor necrosis factor-alpha and interleukin-1 in the mammalian testis and their involvement in testicular torsion and autoimmune orchitis. Reprod Biol Endocrinol. 2004;2:1–10.

    Google Scholar 

  187. Sukhotnik I, Voskoboinik K, Lurie M, et al. Involvement of the bax and bcl-2 system in the induction of germ cell apoptosis is correlated with the time of reperfusion after testicular ischemia in a rat model. Fertil Steril. 2009;92:1466–9.

    PubMed  CAS  Google Scholar 

  188. Celebi M, Paul AG. Blockade of p-selectin reduces neutrophil infiltration into the murine testis after ischemia-reperfusion-injury. Dtsch Tierarztl Wochenschr. 2008;115:457–60.

    PubMed  CAS  Google Scholar 

  189. Celebi M, Paul AG. Blocking E-selectin inhibits ischaemia-reperfusion-induced neutrophil recruitment to the murine testis. Andrologia. 2008;40:235–9.

    PubMed  CAS  Google Scholar 

  190. Ozturk H, Ozturk H, Dokucu AI. The role of cell adhesion molecules in ischemic epididymal injury. Int Urol Nephrol. 2008;40:137–42.

    PubMed  CAS  Google Scholar 

  191. Moon C, Jeong CW, Kim H, et al. Expression of CD44 adhesion molecule in rat testis with ischemia/reperfusion injury. J Vet Med Sci. 2006;68:761–4.

    PubMed  CAS  Google Scholar 

  192. Lysiak JJ, Nguyen QA, Kirby JL, et al. Ischemia-reperfusion of the murine testis stimulates the expression of proinflammatory cytokines and activation of c-Jun NH2-terminal kinase in a pathway to E-selectin expression. Biol Reprod. 2003;69:202–10.

    PubMed  CAS  Google Scholar 

  193. Somuncu S, Cakmak M, Erdogan S, et al. Protective effects of trapidil in ischemia-reperfusion injury due to testicular torsion and detorsion: an experimental study. Int J Urol. 2006;13:601–5.

    PubMed  CAS  Google Scholar 

  194. Ergur BU, Kiray M, Pekcetin C, et al. Protective effect of erythropoietin pretreatment in testicular ischemia-reperfusion injury in rats. J Pediatr Surg. 2008;43:722–8.

    PubMed  Google Scholar 

  195. Yazihan N, Ataoglu H, Koku N, et al. Protective role of erythropoietin during testicular torsion of the rats. World J Urol. 2007;25:531–6.

    PubMed  CAS  Google Scholar 

  196. Akcora B, Altug ME, Kontas T, et al. The protective effect of darbepoetin alfa on experimental testicular torsion and detorsion injury. Int J Urol. 2007;14:846–50.

    PubMed  CAS  Google Scholar 

  197. Ozturk H, Ozturk H, Yagmur Y. PAF antagonist BN-52021 reduces intercellular adhesion molecule-1 expression and oxidative stress in rats with reperfusion damage due to unilateral testicular torsion. Pediatr Surg Int. 2006;22:191–6.

    PubMed  Google Scholar 

  198. Can C, Töre F, Tunçel N, et al. Protective effect of vasoactive intestinal peptide on testicular torsion-detorsion injury: association with heparin-containing mast cells. Urology. 2004;63:195–200.

    PubMed  Google Scholar 

  199. Gokce G, Karboga H, Yildiz E, et al. Effect of angiotensin-converting enzyme inhibition and angiotensin II type 1 receptor blockade on apoptotic changes in contralateral testis following unilateral testicular torsion. Int Urol Nephrol. 2008;40:989–95.

    PubMed  CAS  Google Scholar 

  200. Sozubir S, Barber T, Wang Y, et al. Loss of Insl3: a potential predisposing factor for testicular torsion. J Urol. 2010;183:2373–9.

    PubMed  Google Scholar 

  201. Moon C, Ahn M, Kim S, et al. Increased expression of both constitutive and inducible forms of nitric oxide synthase in the delayed phase of acute experimental testicular torsion. J Vet Med Sci. 2005;67:453–6.

    PubMed  CAS  Google Scholar 

  202. Shiraishi K, Yoshida K, Naito K. Activation of endothelial nitric oxide synthase in contralateral testis during unilateral testicular torsion in rats. Arch Androl. 2003;49:179–90.

    PubMed  CAS  Google Scholar 

  203. Dokucu AI, Oztürk H, Ozdemir E, et al. The protective effects of nitric oxide on the contralateral testis in prepubertal rats with unilateral testicular torsion. BJU Int. 2000;85:767–71.

    PubMed  CAS  Google Scholar 

  204. Barlas M, Hatiboğlu C. The effect of nitric oxide in testicular ischemia-reperfusion injury. Int Urol Nephrol. 2002;34:81–6.

    PubMed  CAS  Google Scholar 

  205. Ozokutan BH, Küçükaydin M, Muhtaroğlu S, et al. The role of nitric oxide in testicular ischemia-reperfusion injury. J Pediatr Surg. 2000;35:101–3.

    PubMed  CAS  Google Scholar 

  206. Dokucu AI, Ozturk H, Ozturk H, et al. The effects of molsidomine on hypoxia inducible factor alpha and Sonic hedgehog in testicular ischemia/reperfusion injury in rats. Int Urol Nephrol. 2009;41:101–8.

    PubMed  CAS  Google Scholar 

  207. Ozturk H, Buyukbayram H, Ozdemir E, et al. The effects of nitric oxide on the expression of cell adhesion molecules (ICAM-1, UEA-1, and tenascin) in rats with unilateral testicular torsion. J Pediatr Surg. 2003;38:1621–7.

    PubMed  Google Scholar 

  208. Gezici A, Ozturk H, Buyukbayram H, et al. Effects of gabexate mesilate on ischemia-reperfusion-induced testicular injury in rats. Pediatr Surg Int. 2006;22:435–41.

    PubMed  Google Scholar 

  209. Sarioglu A, Gedikoglu G, Bingol-Kologlu M, et al. Capsaicin in albino rats prevents contralateral testis from the damaging effects posed by ipsilateral testis that underwent torsion. Eur Urol. 2001;40:469–72.

    PubMed  CAS  Google Scholar 

  210. Karakaya E, Ateş O, Akgür FM, et al. Rosuvastatin protects tissue perfusion in the experimental testicular torsion model. Int Urol Nephrol. 2010;42:357–60.

    PubMed  CAS  Google Scholar 

  211. Romeo C, Antonuccio P, Esposito M, et al. Raxofelast, a hydrophilic vitamin E-like antioxidant, reduces testicular ischemia-reperfusion injury. Urol Res. 2004;32:367–71.

    PubMed  CAS  Google Scholar 

  212. Turan C, Küçükaydin N, Bekerecioğlu A, et al. The effect of vitamin E on ipsilateral and contralateral testis following unilateral testicular torsion in rats. Res Exp Med (Berl). 1996;196:243–6.

    CAS  Google Scholar 

  213. Azizollahi S, Babaei H, Derakhshanfar A, et al. Effects of co-administration of dopamine and vitamin C on ischaemia-reperfusion injury after experimental testicular torsion-detorsion in rats. Andrologia. 2011;43:100–5.

    PubMed  CAS  Google Scholar 

  214. Akgül T, Ayyildiz A, Nuhoğlu B, et al. Ginkgo biloba (EGb 761) usage attenuates testicular injury induced by testicular ischemia/reperfusion in rats. Int Urol Nephrol. 2008;40:685–90.

    PubMed  Google Scholar 

  215. Akgül T, Karagüzel E, Sürer H, et al. Ginkgo biloba (EGB 761) affects apoptosis and nitric-oxide synthases in testicular torsion: an experimental study. Int Urol Nephrol. 2009;41:531–6.

    PubMed  Google Scholar 

  216. Dokmeci D, Akpolat M, Aydogdu N, et al. L-carnitine inhibits ethanol-induced gastric mucosal injury in rats. Pharmacol Rep. 2005;57:481–8.

    PubMed  CAS  Google Scholar 

  217. Dokmeci D, Akpolat M, Aydogdu N, et al. The modifying effect of ibuprofen on total body irradiation-induced elevation of oxidative reactions in male hamsters. Acta Med Biol. 2004;52:67–72.

    CAS  Google Scholar 

  218. Erkin B, Dokmeci D, Altaner S, et al. Gastroprotective effect of L-carnitine on indomethacin-induced gastric mucosal injury in rats: a preliminary study. Folia Med (Plovdiv). 2006;48:86–9.

    Google Scholar 

  219. Tastekin N, Aydogdu N, Dokmeci D, et al. Protective effects of L-carnitine and alpha-lipoic acid in rats with adjuvant arthritis. Pharmacol Res. 2007;56:303–10.

    PubMed  CAS  Google Scholar 

  220. Gurbuz B, Yalti S, Ficicioglu C, et al. Relationship between semen quality and seminal plasma total carnitine in infertile men. J Obstet Gynaecol. 2003;23:653–6.

    PubMed  CAS  Google Scholar 

  221. Lenzi A, Lombardo F, Sgro P, et al. Use of carnitine therapy in selected cases of male factor infertility: a double-blind crossover trial. Fertil Steril. 2003;79:292–300.

    PubMed  Google Scholar 

  222. Matalliotakis I, Koumantaki Y, Evageliou A, et al. L-carnitine levels in the seminal plasma of fertile and infertile men: correlation with sperm quality. Int J Fertil Womens Med. 2000;45:236–40.

    PubMed  CAS  Google Scholar 

  223. Costa M, Canale D, Filicori M, et al. L-carnitine in idiopathic asthenozoospermia: a multicenter study. Italian Study Group on carnitine and male infertility. Andrologia. 1994;26:155–9.

    PubMed  CAS  Google Scholar 

  224. Lenzi A, Sgro P, Salacone P, et al. A placebo-controlled double-blind randomized trial of the use of combined l-carnitine and l-acetyl-carnitine treatment in men with asthenozoospermia. Fertil Steril. 2004;81:1578–84.

    PubMed  CAS  Google Scholar 

  225. Vitali G, Parente R, Melotti C. Carnitine supplementation in human idiopathic asthenospermia: clinical results. Drugs Exp Clin Res. 1995;21:157–9.

    PubMed  CAS  Google Scholar 

  226. Vicari E, Calogero AE. Effects of treatment with carnitines in infertile patients with prostato-vesiculo-epididymitis. Hum Reprod. 2001;16:2338–42.

    PubMed  CAS  Google Scholar 

  227. Vicari E, La Vignera S, Calogero AE. Antioxidant treatment with carnitines is effective in infertile patients with prostatovesiculoepididymitis and elevated seminal leukocyte concentrations after treatment with nonsteroidal anti-inflammatory compounds. Fertil Steril. 2002;78:1203–8.

    PubMed  Google Scholar 

  228. Dokmeci D, Inan M, Basaran UN, et al. Protective effect of L-carnitine on testicular ischaemia-reperfusion injury in rats. Cell Biochem Funct. 2007;25:611–8.

    PubMed  CAS  Google Scholar 

  229. Cankorkmaz L, Köylüoğlu G, Ozer H, et al. The role of apoptosis and protective effect of carnitine in contralateral testicular injury in experimental unilateral testicular torsion. Ulus Travma Acil Cerrahi Derg. 2009;15:529–34.

    PubMed  Google Scholar 

  230. Guan Y, Zheng XM, Yang ZW, et al. Apoptosis of epididymal epithelium and the content of epididymal carnitine following testicular torsion/detorsion in rats. Zhonghua Nan Ke Xue. 2006;12:636–8.

    PubMed  CAS  Google Scholar 

  231. Guan Y, Zheng XM, Yang ZW, et al. Protective effects of L-carnitine upon testicular ischemia-reperfusion damage in rats. Zhonghua Yi Xue Za Zhi. 2009;89:1858–61.

    PubMed  CAS  Google Scholar 

  232. Gürocak S, Yilmaz A, Alp E, et al. Inflammation and oxidative stress in testicular torsion: do they deserve intensive treatment to save both guilty and innocent testes? Urology. 2011;78(1):164–9.

    PubMed  Google Scholar 

  233. Aktaş BK, Bulut S, Bulut S, et al. The effects of N-acetylcysteine on testicular damage in experimental testicular ischemia/reperfusion injury. Pediatr Surg Int. 2010;26:293–8.

    PubMed  Google Scholar 

  234. Cay A, Alver A, Küçük M, et al. The effects of N-acetylcysteine on antioxidant enzyme activities in experimental testicular torsion. J Surg Res. 2006;131:199–203.

    PubMed  CAS  Google Scholar 

  235. Payabvash S, Salmasi AH, Kiumehr S, et al. Salutary effects of N-acetylcysteine on apoptotic damage in a rat model of testicular torsion. Urol Int. 2007;79:248–54.

    PubMed  CAS  Google Scholar 

  236. Koc A, Narci A, Duru M, et al. The protective role of erdosteine on testicular tissue after testicular torsion and detorsion. Mol Cell Biochem. 2005;280:193–9.

    PubMed  CAS  Google Scholar 

  237. Basaran UN, Dokmeci D, Yalcin O, et al. Effect of curcumin on ipsilateral and contralateral testes after unilateral testicular torsion in a rat model. Urol Int. 2008;80:201–7.

    PubMed  Google Scholar 

  238. Wei SM, Yan ZZ, Zhou J. Curcumin attenuates ischemia-reperfusion injury in rat testis. Fertil Steril. 2009;91:271–7.

    PubMed  CAS  Google Scholar 

  239. Gökçe A, Oktar S, Koc A, et al. Protective effect of thymoquinone in experimental testicular torsion. Urol Int. 2010;85:461–5.

    PubMed  Google Scholar 

  240. Tamamura M, Saito M, Kinoshita Y, et al. Protective effect of edaravone, a free-radical scavenger, on ischaemia-reperfusion injury in the rat testis. BJU Int. 2010;105:870–6.

    PubMed  CAS  Google Scholar 

  241. Uguralp S, Mizrak B, Bay Karabulut A. Resveratrol reduces ischemia reperfusion injury after experimental testicular torsion. Eur J Pediatr Surg. 2005;15:114–9.

    PubMed  CAS  Google Scholar 

  242. Uguralp S, Usta U, Mizrak B. Resveratrol may reduce apoptosis of rat testicular germ cells after experimental testicular torsion. Eur J Pediatr Surg. 2005;15:333–6.

    PubMed  CAS  Google Scholar 

  243. He QX, Zhang YG, Hu X, et al. Tea polyphenols protects the testis following testicular torsion/detorsion in rats. Zhonghua Nan Ke Xue. 2010;16:615–8.

    PubMed  CAS  Google Scholar 

  244. Unsal A, Eroglu M, Avci A, et al. Protective role of natural antioxidant supplementation on testicular tissue after testicular torsion and detorsion. Scand J Urol Nephrol. 2006;40:17–22.

    PubMed  Google Scholar 

  245. Etensel B, Ozkisacik S, Ozkara E, et al. Dexpanthenol attenuates lipid peroxidation and testicular damage at experimental ischemia and reperfusion injury. Pediatr Surg Int. 2007;23:177–81.

    PubMed  Google Scholar 

  246. Etensel B, Ozkisacik S, Ozkara E, et al. The protective effect of dexpanthenol on testicular atrophy at 60th day following experimental testicular torsion. Pediatr Surg Int. 2007;23:271–5.

    PubMed  Google Scholar 

  247. Avlan D, Erdouğan K, Cimen B, et al. The protective effect of selenium on ipsilateral and contralateral testes in testicular reperfusion injury. Pediatr Surg Int. 2005;21:274–8.

    PubMed  Google Scholar 

  248. Atik E, Görür S, Kiper AN. The effect of caffeic acid phenethyl ester (CAPE) on histopathological changes in testicular ischemia-reperfusion injury. Pharmacol Res. 2006;54:293–7.

    PubMed  CAS  Google Scholar 

  249. Koltuksuz U, Irmak MK, Karaman A, et al. Testicular nitric oxide levels after unilateral testicular torsion/detorsion in rats pretreated with caffeic acid phenethyl ester. Urol Res. 2000;28:360–3.

    PubMed  CAS  Google Scholar 

  250. Uz E, Söğüt S, Sahin S, et al. The protective role of caffeic acid phenethyl ester (CAPE) on testicular tissue after testicular torsion and detorsion. World J Urol. 2002;20:264–70.

    PubMed  CAS  Google Scholar 

  251. Adivarekar PK, Bhagwat SS, Raghavan V, et al. Effect of Lomodex-MgSO4 in the prevention of reperfusion injury following unilateral testicular torsion: an experimental study in rats. Pediatr Surg Int. 2005;21:184–90.

    PubMed  Google Scholar 

  252. Abes M, Sarihan H, Deger O, et al. The effect of ATP-MgCl2 on prevention of reperfusion injury after unilateral testicular torsion. Eur J Pediatr Surg. 2001;11:255–8.

    PubMed  CAS  Google Scholar 

  253. Ozkan KU, Boran C, Kilinç M, et al. The effect of zinc aspartate pretreatment on ischemia-reperfusion injury and early changes of blood and tissue antioxidant enzyme activities after unilateral testicular torsion-detorsion. J Pediatr Surg. 2004;39:91–5.

    PubMed  CAS  Google Scholar 

  254. Wei SM, Yan ZZ, Zhou J. Beneficial effect of taurine on testicular ischemia-reperfusion injury in rats. Urology. 2007;70:1237–42.

    PubMed  Google Scholar 

  255. Dokmeci D, Akpolat M, Aydogdu N, et al. The protective effect of L-carnitine on ionizing radiation-induced free oxygen radicals. Scand J Lab Anim Sci. 2006;33:75–83.

    CAS  Google Scholar 

  256. Dokmeci D. Ibuprofen and Alzheimer’s disease. Folia Med (Plovdiv). 2004;46:5–10.

    Google Scholar 

  257. Dokmeci D. The role of peroxisome proliferator-activated receptors in Alzheimer’s disease. In: Welsh EM, editor. New research on Alzheimer’s disease. New York: Nova Science Publishers; 2006. p. 125–63.

    Google Scholar 

  258. Dokmeci D, Kanter M, Inan M, et al. Protective effects of ibuprofen on testicular torsion/detorsion-induced ischemia/reperfusion injury in rats. Arch Toxicol. 2007;81:655–63.

    PubMed  CAS  Google Scholar 

  259. Inan M, Basaran U, Dokmeci D, et al. Rosiglitazone, an agonist of peroxisome proliferator-activated receptor-gamma, prevents contralateral testicular ischaemia-reperfusion injury in prepubertal rats. Clin Exp Pharmacol Physiol. 2007;34:457–61.

    PubMed  CAS  Google Scholar 

  260. Mogilner JG, Lurie M, Coran AG, et al. Effect of diclofenac on germ cell apoptosis following testicular ischemia-reperfusion injury in a rat. Pediatr Surg Int. 2006;22:99–105.

    PubMed  Google Scholar 

  261. Minutoli L, Antonuccio P, Polito F, et al. Peroxisome proliferator activated receptor beta/delta activation prevents extracellular regulated kinase 1/2 phosphorylation and protects the testis from ischemia and reperfusion injury. J Urol. 2009;181:1913–21.

    PubMed  CAS  Google Scholar 

  262. Salmasi AH, Beheshtian A, Payabvash S, et al. Effect of morphine on ischemia-reperfusion injury: experimental study in testicular torsion rat model. Urology. 2005;66:1338–42.

    PubMed  Google Scholar 

  263. Liu ZM, Zheng XM, Yang ZW, et al. Protective effect of pentoxifylline on spermatogenesis following testicular torsion/detorsion in rats. Zhonghua Nan Ke Xue. 2006;12:323–5.

    PubMed  Google Scholar 

  264. Savaş C, Dindar H, Aras T, et al. Pentoxifylline improves blood flow to both testes in testicular torsion. Int Urol Nephrol. 2002;33:81–5.

    PubMed  Google Scholar 

  265. Savas C, Dindar H, Bilgehan A, et al. Pentoxifylline attenuates reperfusion injury in testicular torsion. Scand J Urol Nephrol. 2002;36:65–70.

    PubMed  CAS  Google Scholar 

  266. Greenstein A, Schreiber L, Matzkin H. The effect of methylene blue on histological damage after spermatic cord torsion in a rat model. BJU Int. 2001;88:90–2.

    PubMed  CAS  Google Scholar 

  267. Inan M, Basaran UN, Dokmeci D, et al. Methylene blue increases contralateral testicular ischaemia-reperfusion injury after unilateral testicular torsion. Clin Exp Pharmacol Physiol. 2008;35:50–4.

    PubMed  CAS  Google Scholar 

  268. Unsal A, Devrim E, Guven C, et al. Propofol attenuates reperfusion injury after testicular torsion and detorsion. World J Urol. 2004;22:461–5.

    PubMed  Google Scholar 

  269. Yagmurdur H, Ayyildiz A, Karaguzel E, et al. The preventive effects of thiopental and propofol on testicular ischemia-reperfusion injury. Acta Anaesthesiol Scand. 2006;50:1238–43.

    PubMed  CAS  Google Scholar 

  270. Yagmurdur H, Ayyildiz A, Karaguzel E, et al. Propofol reduces nitric oxide-induced apoptosis in testicular ischemia-reperfusion injury by downregulating the expression of inducible nitric oxide synthase. Acta Anaesthesiol Scand. 2008;52:350–7.

    PubMed  CAS  Google Scholar 

  271. Harvey M, Chanwai G, Cave G. Manual testicular detorsion under propofol sedation. Case Report Med. 2009;2009:529346.

    PubMed  Google Scholar 

  272. Nezami BG, Rahimpour S, Gholipour T, et al. Protective effects of immunophilin ligands on testicular torsion/detorsion damage in rats. Int Urol Nephrol. 2009;41:93–9.

    PubMed  CAS  Google Scholar 

  273. Ozen IO, Vural IM, Moralioğlu S, et al. Effects of mexiletine on electrical field stimulation-induced contractile responses in the ipsilateral and contralateral vasa deferentia after unilateral testicular torsion/detorsion. Eur Surg Res. 2006;38:423–9.

    PubMed  Google Scholar 

  274. Abasiyanik A, Dağdönderen L. Beneficial effects of melatonin compared with allopurinol in experimental testicular torsion. J Pediatr Surg. 2004;39:1238–41.

    PubMed  Google Scholar 

  275. Akgür FM, Kilinç K, Aktuğ T, et al. The effect of allopurinol pretreatment before detorting testicular torsion. J Urol. 1994;151:1715–7.

    PubMed  Google Scholar 

  276. Kehinde EO, Anim JT, Mojiminiyi OA, et al. Allopurinol provides long-term protection for experimentally induced testicular torsion in a rabbit model. BJU Int. 2005;96:175–80.

    PubMed  Google Scholar 

  277. Silva AC, Ortiz V, Silva RA, et al. Effect of allopurinol on rat testicles morphology, submitted to ischaemia for spermatic cord torsion followed by reperfusion. Acta Cir Bras. 2005;20:468–72.

    PubMed  Google Scholar 

  278. Barun S, Ekingen G, Mert Vural I, et al. The effects of melatonin on electrical field stimulation-evoked biphasic twitch responses in the ipsilateral and contralateral rat vasa deferentia after unilateral testicular torsion/detorsion. Naunyn Schmiedebergs Arch Pharmacol. 2005;371:351–8.

    PubMed  CAS  Google Scholar 

  279. Ozturk A, Baltaci AK, Mogulkoc R, et al. The effect of prophylactic melatonin administration on reperfusion damage in experimental testis ischemia-reperfusion. Neuro Endocrinol Lett. 2003;24:170–2.

    PubMed  CAS  Google Scholar 

  280. Duru FI, Noronha CC, Akinwande AI, et al. Effects of torsion, detorsion and melatonin on testicular malondialdehyde level. West Afr J Med. 2007;26:312–5.

    PubMed  CAS  Google Scholar 

  281. Yurtçu M, Abasiyanik A, Avunduk MC, et al. Effects of melatonin on spermatogenesis and testicular ischemia-reperfusion injury after unilateral testicular torsion-detorsion. J Pediatr Surg. 2008;43:1873–8.

    PubMed  Google Scholar 

  282. Yurtçu M, Abasiyanik A, Biçer S, et al. Efficacy of antioxidant treatment in the prevention of testicular atrophy in experimental testicular torsion. J Pediatr Surg. 2009;44:1754–8.

    PubMed  Google Scholar 

  283. Jeong SJ, Choi WS, Chung JS, et al. Preventive effects of cyclosporine a combined with prednisolone and melatonin on contralateral testicular damage after ipsilateral torsion-­detorsion in pubertal and adult rats. J Urol. 2010;184:790–6.

    PubMed  CAS  Google Scholar 

  284. Kanter M. Protective effects of melatonin on testicular torsion/detorsion-induced ischemia-reperfusion injury in rats. Exp Mol Pathol. 2010;89:314–20.

    PubMed  CAS  Google Scholar 

  285. Kucer Z, Hekimoglu A, Aral F, et al. Effect of melatonin on epididymal sperm quality after testicular ischemia/reperfusion in rats. Fertil Steril. 2010;93:1545–9.

    Google Scholar 

  286. Yazawa H, Sasagawa I, Suzuki Y, et al. Glucocorticoid hormone can suppress apoptosis of rat testicular germ cells induced by testicular ischemia. Fertil Steril. 2001;75:980–5.

    PubMed  CAS  Google Scholar 

  287. Cho YM, Pu HF, Huang WJ, et al. Role of serum- and glucocorticoid-inducible kinase-1 in regulating torsion-induced apoptosis in rats. Int J Androl. 2011;34(4):379–89. doi:10.1111/j.1365-2605.2010.01091.x.

    PubMed  CAS  Google Scholar 

  288. Yapanoglu T, Aksoy Y, Gursan N, et al. Antiapoptotic effects of dehydroepiandrosterone on testicular torsion/detorsion in rats. Andrologia. 2008;40:38–43.

    PubMed  CAS  Google Scholar 

  289. Aksoy H, Yapanoglu T, Aksoy Y, et al. Dehydroepiandrosterone treatment attenuates reperfusion injury after testicular torsion and detorsion in rats. J Pediatr Surg. 2007;42:1740–4.

    PubMed  Google Scholar 

  290. Unal D, Karatas OF, Savas M, et al. Protective effects of trimetazidine on testicular ischemia-reperfusion injury in rats. Urol Int. 2007;78:356–62.

    PubMed  CAS  Google Scholar 

  291. Savaş C, Ozgüner M, Ozgüner F, et al. The effects of human chorionic gonadotropin treatment on the contralateral side in unilateral testicular torsion. Int Urol Nephrol. 2003;35:237–45.

    PubMed  Google Scholar 

  292. Kolski JM, Mazolewski PJ, Stephenson LL, et al. Effect of hyperbaric oxygen therapy on testicular ischemia-reperfusion injury. J Urol. 1998;160:601–4.

    PubMed  CAS  Google Scholar 

  293. Palmer JS, Cromie WJ, Lee RC. Surfactant administration reduces testicular ischemia-­reperfusion injury. J Urol. 1998;159:2136–9.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pharmacology, Faculty of Medicine, Trakya University, 22030, Edirne, Turkey

    Dikmen Dokmeci MD, PhD

Authors
  1. Dikmen Dokmeci MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dikmen Dokmeci MD, PhD .

Editor information

Editors and Affiliations

  1. Center for Reproductive Medicine, Department of Urology, Cleveland Clinic, Euclid Avenue 9500, Cleveland, 44195, Ohio, USA

    Ashok Agarwal

  2. Faculty of Science and IT, Department of Biological Sciences, University of Newcastle, University Drive 1, Callaghan, 2308, New South Wales, Australia

    R. John Aitken

  3. , Department of Male Infertility, Centro Androgen, C/FERNANDO MACIAS 8, 1ºC, La Coruña, 15004, La Coruña, Spain

    Juan G. Alvarez

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Dokmeci, D. (2012). Oxidative Stress and Testicular Torsion. In: Agarwal, A., Aitken, R., Alvarez, J. (eds) Studies on Men's Health and Fertility. Oxidative Stress in Applied Basic Research and Clinical Practice. Humana Press. https://doi.org/10.1007/978-1-61779-776-7_17

Download citation

Publish with us

Policies and ethics

Search

Navigation