Testicular Salvage Following Spermatic Cord Torsion

There have been several reports indicating that men who have suffered from spermatic cord torsion are likely to have abnormal seminal analyses. It is now well recognized that unilateral spermatic cord torsion can result in contralateral testicular damage. This study was instituted to evaluated possible methods of preventing post-torsion contralateral testicular damage. Experimental torsion was produced in 250 g Wistar rats. The duration of torsion was either 3,6 or 24 hours. The rats were then treated by one of three methods, namely, (1) detorsion, (2) immediate ipsilateral orchidectomy, or (3) detorsion and adjuvant immunotherapy. Contralateral testicular damage was prevented by immediate ipsilateral orchidectomy and by detorsion with adjuvant immunotherapy. The immunotherapeutic agents administered were either hydrocortisone, azathioprine, or cyclosporin A. The results strongly support the premise that detorsion with adjuvant immunotherapy results in salvage of the ipsilateral testis while preventing contralateral testicular damage. Hydrocortisone is the immunotherapeutic agent of choice because its administration was associated with the fewest complications.