Evaluation of the morphologic and histologic changes in the testes after spermatic vessels division (fowler-stephens maneuver)‎ : an experimental study

Abstract EN

Background/Aim : orchiopexy with division of the spermatic vessels is a commonly used technique for correcting the high undescended testis using either one or two stage Fowler-Stephens procedure.

We aimed in this study to determine early and late morphological and histological changes in the ipsilateral and contralateral testes after unilateral testicular vessels division in rat.

Materials & Methods : Four groups, each of 12 prepubertal male albino rats were studied.

Group I was a control group without any operative intervention and group II underwent sham operation on the left testis and spermatic cord.

Group III underwent in situ left high spermatic vessels division and in group IV, the left spermatic vessels were divided at the same level as in group III, but the spermatic cord and testis were completely dissected and reed from any attachment in the abdomen and scrotum.

Six prepubertal rats in each group were sacrificed one day postoperatively.

The remaining 6 prepubertal rats in all groups were sacrificed 4 weeks postoperatively after reaching maturity to evaluate spermatogenesis.

For each rat, the testes were harvested bilaterally and prepared or histological examination of testicular architecture and evaluation of spermatogenesis.

The volume of each testis was calculated.

Results : in group III, all testes one day and 4 weeks postoperatively showed no significant changes in the size and shape compared to the control group.

One day postoperatively, in-situ division of the spermatic vessels caused morphological changes in primary spermatocytes at all stages of the cycle in the ipsilateral testes.

These morphological changes have become normalized after 4 weeks.

In group IV, all the ipsilateral testes one day postoperatively showed no significant differences in the testicular shape, size and weight compared to the control group, however, these ipsilateral testes 4 weeks postoperatively, showed statistically significant decrease in weight compared to the control.

Histologically, one day postoperatively, more histological alterations were occurred and most of pachytene spermatocytes, at all stages of the cycle, showed marked chromatin condensation and acidophilic cytoplasm.

Four weeks postoperatively, two testes showed normalization of the morphological changes, however, in 3 testes; the severe alterations and cell degeneration observed after one day were amplified and the entire population of pachytene spermatocytes disappeared from most of the seminiferous tubules, although infrequent nests of complete spermatogenesis have been observed (<30 %).

In one testis, the entire population of the germinal cells was eliminated and the tubules were lined exclusively by Sertolice Us.

The contralateral testes in both groups III and IV showed no significant difference either macroscopically or microscopically one day and 4 weeks postoperatively.

Conclusions : The spermatic artery and vein can safely be divided above the divergence of the vas to provide additional cord length.

Division of the spermatic vessels may result in varying degrees of testicular injury.

Often this injury is much greater histologically than one would expect from gross examination of the testis.

It is important to divide the spermatic vessels in a separate procedure before orchiopexy.

The effects of testicular injury on the sperm production in the contralateral testis are not reported in rats and did not result in any decrease in spermatogenesis.