Primary testicular lesions in the twisted testis.

OBJECTIVE

To investigate primary lesions in twisted testes.

METHODS

The histologic study of testicular specimens obtained from men who had suffered testicular torsion.

METHODS

The conditions required for material selection were the knowledge of the exact time of torsion and the presence of recognizable seminiferous epithelium cells.

METHODS

Two hundred eighteen testicular torsions treated in La Paz Hospital, Madrid, Spain, from 1970 to 1990.

METHODS

After rejection of specimens that did not fulfill the conditions for selection, 109 biopsy and orchidectomy specimens from pubertal and adult males were studied to determine if primary lesions are superimposed to lesions secondary to anoxia.

RESULTS

The following primary tubular lesions were found: (1) focal hypospermatogenesis (5 biopsies and 1 orchidectomy specimen; these testes showed degree I, II, or III anoxic lesions); (2) hypoplastic zones with only immature and hyperplastic Sertoli cells (3 orchidectomy specimens with degree III lesions); (3) zones of Sertoli-cell-only tubules that only contained a normal amount of mature appearing Sertoli cells (5 orchidectomy specimens with degree III lesions); and (4) intratubular calcifications (1 orchidectomy specimen with degree III lesions). In two cases with degree III lesions, more than one primary testicular lesion could be observed.

CONCLUSIONS

An important number of twisted testes bear primary lesions that might had been involved in torsion development. The real percentage is probably even higher than that found in this study (14%) because the material obtained (biopsies) in many cases was insufficient to ensure complete exploration and because primary lesions are not recognizable in areas with pronounced anoxic lesions.