Deneysel testiküler atrofide orşiektominin fertiliteye etkisinin araştırılması
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Dosyalar
Tarih
2014
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışmanın amacı, puberte öncesi testis atrofisi oluşan erkeklerde orşiektominin fertilite üzerine olumlu ya da olumsuz etkisini araştırmak; araştırmanın sonucuna göre, atrofik testis tespit edilen erkeklerde fertilite açısından cerrahinin gerekli olup olmayacağına karar vermektir. Yöntem Çalışmamızda 18 adet prepubertal, 6 adet pubertal Wistar erkek sıçan kullanıldı. Sıçanlar kontrol, atrofi ve orşiektomi olmak üzere 3 gruba ayrıldı. Kontrol grubu (K), 6 adet pubertal sıçandan oluştu. Herbir sıçan 5' er adet dişi ile 6 gün çiftleştirildi. Atrofi grubunda (A) 720o sol testis torsiyonu oluşturuldu. Yaklaşık 40 gün sonra atrofi oluştuğu tespit edildi. Orşiektomi grubunda (O) da 720o sol testis torsiyonu oluşturuldu. Atrofi oluştuktan sonra sol orşiektomi yapıldı. İyileşme sürecinden sonra herbir sıçan 5' er adet dişi ile 6 gün çiftleştirildi. Bütün gruplarda çiftleşme işlemi sonrası, yüksek doz anestezik madde verilip ratlara bilateral orşiektomi uygulandı. Histopatolojik inceleme ile Johnson skorları (JS) belirlendi. İntrakardiak kan alınarak inhibin B (İB) seviyesine bakıldı. Ayrıca fertilitenin değerlendirilmesi için gebelik tespiti yapıldı. Atrofik testis dokusu ipsilateral, sağ testis kontralateral olarak adlandırıldı. Bulgular Doku JS'ları açısından ipsilateral testisler incelendiğinde, K grubu ile O grubu (P=0,000); K grubu ile A grubu (P=0,000) arasında anlamlı fark olduğu tespit edildi. O grubu ile A grubu ipsilateral testis dokuları JS'ları arasında anlamlı fark olmadığı saptandı (P=0,654). Kontralateral testis dokusu JS'ları arasında ise, gruplar arasında anlamlı fark olmadığı tespit edildi (P=0,372). Serum İB değerleri açısından, gruplar arasında anlamlı fark olmadığı saptandı (P=0,243). Fertilite yüzdeleri incelendiğinde, K grubu ile O grubu (P=0,015); K grubu ile A grubu (P=0,015) arasında anlamlı farkın olduğu tespit edildi. Ayrıca O grubu ile A grubu arasında, fertilite yüzdeleri açısından anlamlı fark olmadığı tespit edildi (P=1,000). Sonuç Bu bulgulara göre inhibin B, JS ve fertilite parametreleri incelendiğinde atrofi ve orşiektomi grupları arasında anlamlı fark olmadığı tespit edildi. Çalışmamız deneysel bir çalışma olmasına rağmen, prepubertal dönemdeki çocuklarda çeşitli nedenlerle oluşabilecek testis atrofisinin; fertilite üzerine olumsuz etkisinin olmadığı sonucuna varılmıştır. Atrofik testis dokusuna yapılacak orşiektominin anlamlı bir etkisinin olmadığı saptandığından cerrahi işlemlerin yapılmaması gerektiğini düşünüyoruz. Anahtar Kelimeler Atrofi; İnhibin B; Fertilite
The aim of this study is to analyse the positive or negative effects of orchiectomy over fertility among males who have pre-puberty testis atrophy and according to the result of the study to decide whether the surgery is necessary or not in the sense of fertility among males who have atrophy of testis. Method In this study, six pubertal and eighteen prepubertal Wistar male rats have been used. The rats have been divided into three groups as the control group, the atrophy group and orchiectomy group. The control group (K) included six pubertal rats. Each rat has been mated with five female rats for six days. In the atrophy group (A), 7200 left testis torsion has been formed. Almost forty days later, it has been confirmed that there was atrophy. In the orchiectomy group (O), 7200 left testis torsion has been formed, too. After the formation of atrophy, left orchiectomy was applied. At the end of the healing process, each rat has been mated with five female rats for six days. In all three groups, after the mating process, bilateral orchiectomy has been performed on rats by giving them high dose anaesthetics. Through histopathological examinations Johnson scores (JS) were determined. By drawing intracardiac blood, inhibin B levels (IB) were examined. Besides, in order to evaluate the fertility, rats had a pregnancy test. The atrophic testis tissue was named as ipsilateral and right testis was named as contralateral. Findings When we examine the ipsilateral testis from the point of tissue JSs, it has been found out that there has been a meaningful difference among group K and group O (P=0,000); group K and group A (P=0,000). It has been confirmed that there has not been a meaningful difference in ipsilateral testis tissue JSs among group O and group A (P=0,654). And from the point of contralateral testis tissue JSs, it has been identified that there has not been a meaningful difference among groups (P=0,372). In serum IB levels, it has been found out that there has not been a meaningful difference among groups (P=0,243). When we examine the fertility percentages, it has been confirmed that there has been a meaningful difference among group K and group O (P=0,015); group K and group A (P=0,015). Besides, from the point of fertility percentages, it has been determined that there has not been a meaningful difference among group O and group A (P=1,000). Results According to these findings; when inhibin B, JS and fertility parameters are examined, it can be seen that, there has not been a meaningful difference between atrophy and orchiectomy groups. In light of this information, even though our study has been an experimental one, it has been concluded that, there has not been a negative effect of testis atrophy which may occur due to various reasons among pre-pubertal children over fertility. As it is confirmed that the orchiectomy which is performed in atrophic testis tissue does not have a meaningful effect, we are in the opinion of not performing surgical operations. Key words Atrophy; Inhibin B; Fertility
The aim of this study is to analyse the positive or negative effects of orchiectomy over fertility among males who have pre-puberty testis atrophy and according to the result of the study to decide whether the surgery is necessary or not in the sense of fertility among males who have atrophy of testis. Method In this study, six pubertal and eighteen prepubertal Wistar male rats have been used. The rats have been divided into three groups as the control group, the atrophy group and orchiectomy group. The control group (K) included six pubertal rats. Each rat has been mated with five female rats for six days. In the atrophy group (A), 7200 left testis torsion has been formed. Almost forty days later, it has been confirmed that there was atrophy. In the orchiectomy group (O), 7200 left testis torsion has been formed, too. After the formation of atrophy, left orchiectomy was applied. At the end of the healing process, each rat has been mated with five female rats for six days. In all three groups, after the mating process, bilateral orchiectomy has been performed on rats by giving them high dose anaesthetics. Through histopathological examinations Johnson scores (JS) were determined. By drawing intracardiac blood, inhibin B levels (IB) were examined. Besides, in order to evaluate the fertility, rats had a pregnancy test. The atrophic testis tissue was named as ipsilateral and right testis was named as contralateral. Findings When we examine the ipsilateral testis from the point of tissue JSs, it has been found out that there has been a meaningful difference among group K and group O (P=0,000); group K and group A (P=0,000). It has been confirmed that there has not been a meaningful difference in ipsilateral testis tissue JSs among group O and group A (P=0,654). And from the point of contralateral testis tissue JSs, it has been identified that there has not been a meaningful difference among groups (P=0,372). In serum IB levels, it has been found out that there has not been a meaningful difference among groups (P=0,243). When we examine the fertility percentages, it has been confirmed that there has been a meaningful difference among group K and group O (P=0,015); group K and group A (P=0,015). Besides, from the point of fertility percentages, it has been determined that there has not been a meaningful difference among group O and group A (P=1,000). Results According to these findings; when inhibin B, JS and fertility parameters are examined, it can be seen that, there has not been a meaningful difference between atrophy and orchiectomy groups. In light of this information, even though our study has been an experimental one, it has been concluded that, there has not been a negative effect of testis atrophy which may occur due to various reasons among pre-pubertal children over fertility. As it is confirmed that the orchiectomy which is performed in atrophic testis tissue does not have a meaningful effect, we are in the opinion of not performing surgical operations. Key words Atrophy; Inhibin B; Fertility
Açıklama
Anahtar Kelimeler
Atrofi, Atrophy, Kısırlık, Infertility, Kısırlık-erkek, Infertility-male, Orşiektomi, Orchiectomy, Testis, Testis, İnhibinler, Inhibins
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Loğoğlu, M. (2014). Deneysel testiküler atrofide orşiektominin fertiliteye etkisinin araştırılması. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Çocuk Cerrahisi Anabilim Dalı, Konya.
