The efficiacy of l-carnitine in restoring the damage caused by testicular torsion

Testis torsion which is often seen in males and which can result in gonad loss if it is not treated is one of the urological emergency cases. Although it can be seen in every age group, it especially peaks at puberty and first year.When the literature is reviewed, it is seen that the studies about using carnitine in testis torsion are limited, and in a unique study on this subject the effects of carnitine in testis torsion are investigated and when the results are assessed histopathologically carnitine treatment has been found effective.In this study that we carried out on Wistar albino rats, we aimed to determine the effects of L-carnitine which will be used during reperfusion phase formed by detorsion on torsioned testis and contralateral testis by testis sintigraphy, and to assess the results histopathologically.20 male Wistar-Albino rats were included in the study. Rats were divided into three groups.*Sham group (n=4),*Ischemia/Reperfüsion group (I/R) (n=8)*I/R + Carnitine group (n=8).Baseline testis scintigraphy of all groups were taken under ketamin anesthesia. 24 hours later tunica vaginalis is opened in the sham group rats. Then testes were freed, without torsion by passing through tunica albuginea with silk sutures and connected to the scrotum. Then, the right testes of the rats in I/R and I/R + carnitine groups were torsioned 720º in the clockwise direction and connected to the scrotum for 4 hours. After this 4 hours in order to image torsion, testis scintigraphies of the rats in I/R and I/R + Carnitine groups were taken again. Then, reperfusion was obtained by detorsioning the right testes of the rats in these two groups. While the I/R group was given 1cc intraperitoneal isotonic, I/R + carnitine group was given 500mg/kg intraperitoneal L-carnitine and these doses were repeated after 8 hours. 20 hours after detorsion, testis scintigraphies of the rats in I/R and I/R + Carnitine groups were taken again. After these processes, the rats in these three groups were sacrified and testes of the rats in each group were taken and assessed histopathologically.As a result, in the testis scintigraphies that were taken 20 hours after detorsion, in the right testis (torsioned), a statistically significant difference in respect of holding radioactive substance in favour of I/R + Carnitine group has been found compared to I/R group (p<0,05). In respect of holding radioactive substance no statistically significant difference found between two groups, in the contralateral testis (p>0,05).In the histopathological assessment, in the sections of the right testes (torsioned) of the rats in the I/R + Carnitine group, except for interstitial eudema and congession in the stromal tissues nearly normal statement was viewed.In respect to these findings, we consider that, the treatment of carnitine during reperfusion phase in the treatment of testis torsion will have positive effects in preventing the damage of I/R.