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. 2009 Apr;41(1):22-7.

The protective effect of dehydroepiandrosterone on ovarian tissues after torsion-detorsion injury: a stereological and histopathological study

Bunyamin Borekci  1 , Cemal Gundogdu  2 , B Zuhal Altunkaynak  3 , Muhammed Calık  2 , M Eyup Altunkaynak  3 , Deniz Unal  3 , Bunyami Unal  3
Affiliations

The protective effect of dehydroepiandrosterone on ovarian tissues after torsion-detorsion injury: a stereological and histopathological study

Bunyamin Borekci et al. Eurasian J Med. 2009 Apr.

Abstract
in English, Turkish

Objective: Ovarian torsion is a rare problem in pre-pubescent girls that must be included in the differential diagnosis of patients with abdominal or pelvic pain. Current advice for treatment to support ovary preservation considers the macroscopic appearance of the ovary, but this is not a reliable indicator of the degree of injury in cases of ovarian torsion. The aim of this study was to determine the effects of dehydroepiandrosterone (DHEA) treatment on the rat ovary after torsion-detorsion injury using a histopathological approach and stereological methods.

Materials and methods: Fifteen adult female Sprague Dawley rats were divided into three groups: sham operated (Control; n=5), torsion-detorsion with saline (Saline; n = 5), and torsion-detorsion with DHEA (DHEA; n = 5). Rats in the sham-operated group underwent a surgical procedure similar to the other groups, but the adnexa were not torsioned. The DHEA group was injected intraperitoneally 3 hours before detorsion and saline was administered to the saline group. After 24 h of adnexal detorsion, the rats in all groups were sacrificed and the adnexa were removed. The volume of ovarian stroma and edema were estimated using the Cavalieri Principle and were applied to serial paraffin sections. Ovary sections were also evaluated histopathologically.

Results: The volume of ovarian edema was 35.4% lower in the saline group compared to the control group (p> 0.05). The volume of ovarian edema increased by 73.4% in the DHEA group (p<0.05). In the experimental groups, stromal volume was 41.0% higher in the saline group and 52% higher in the DHEA group in comparison to the control group. Statistically significant differences were found when comparing the volume of both ovarian edema and stroma between experimental groups (Detorsion/Saline group - Detorsion/DHEA group; p< 0.01). Histopathologically, mononuclear cell infiltration and vascular dilatation, perivascular edema and common necrotic changes were obvious in the torsion-detorsion damaged ovary. These changes were partially ameliorated by DHEA treatment.

Conclusions: The present study shows that administration of DHEA has beneficial effects in the prevention of ischemia-reperfusion injuries of the ovaries.

Amaç: Over torsiyonu puberte öncesinde, nadir görülen bir problem olup hastalığın tanısında abdominal ya da pelvic ağrı hikayesi önemlidir. Tedavi için overin makroskobik görünümü dikkate alınmalıdır. Ancak makroskobik görünüm hasarın derecesini tahmin için tek yeterli kriter değildir. Bu çalışmanın amacı dihidroepiandrosteron (DHEA) tedavisinin tosiyon-detorsiyon hasarı üzerine etkisini histolojik yaklaşım ve stereolojik yöntemle değerlendirmektir.

Gereç ve yöntem: Bu çalışma için kullanılan 15 adet erişkin, Sprague Dawley cinsi sıçan Şam –operasyon grubu, torsiyondetorsiyon-serum fizyolojik grubu ve torsiyon-detorsiyon-DHEA tedavi grubu olmak üzere 3 eşit gruba ayrıldı. Şam operasyon grubundaki sıçanlar diğer gruplarla torsiyon prosedürü hariç aynı cerrahi işlemlere tabi tutuldu. DHEA ve serum fizyolojik grupları detorsiyon işleminden önce intraperitoneal yolla serum fizyolojik ve DHEA aldı. Detorsiondan 24 saat sonra tüm gruplardaki denekler öldürülerek overleri çıkarıldı. Histolojik takip sonucu elde edilen doku örneklerinden alınan seri paraffin kesitler üzerinde over stroması ve ödem hacimleri hesaplandı. Ayrıca over kesitleri histopatolojik açıdan da değerlendirildi.

Bulgular: Bu çalışmadan elde edilen bulgulara göre torsiyondetorsiyon işlemine tabi tutulan gruplardan serum fizyolojik uygulanan grupta over ödemi %35 azaldı. DHEA grubunda ise %73.4 arttı. Stroma hacmi ise serum fizyolojik grubunda %52 DHEA grubunda %41 arttı. Hem ödem hem de stroma hacmi açısından serum fizyolojik ve DHEA grupları arasında anlamlı fark bulundu. Tedavi edilmeyen torsiyon-detorsiyon grubunda, histopatolojik olarak; mononükleer hücre infiltrasyonu, vasküler dilatasyon, perivasküler ödem ve nekrotik değişiklikler gerçekleştiği gözlendi. Bu değişiklikler DHEA tedavisi ile kısmen düzeltilebil mekteydi.

Sonuç: Bu çalışmada DHEA’nın torsiyon-detorsiyon işleminden kaynaklanan iskemi-reperfüzyon hasarının tedavisinde faydalı olabileceği ilk kez gösterilmiştir.

Keywords: Cavalieri Principle; DHEA; Histopathology; Ovarian torsion; Stereology.

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Figures

Fig. 1
Fig. 1
Surgical procedures applied in this study. A. Median laparotomy of female rats. B. Torsion process. C. Detorsioned ovary, attached to abdominal muscles. D. Ovaries removed for histopathological and stereological procedures.
Fig. 2
Fig. 2
Stereological process involved in two different estimations by the Stereo Investigator. A. Line-drawn ovarian stroma. B. Estimation map of images in A. C. Line-drawn ovarian edema. D. Estimation map of images in C.
Fig. 3
Fig. 3
Volumetric values of ovarian edema ± SD in all groups.
Fig. 4
Fig. 4
Volumetric values of ovarian stroma ± SD in all groups.
See this image and copyright information in PMC

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References

    1. Takeda A, Manabe S, Hosono S, Nakamura H. Laparoscopic surgery in 12 cases of adnexal disease occurring in girls aged 15 years or younger. J Minim Invasive Gynecol. 2005;12:234–40. - PubMed
    1. Vijayaraghavan SB. Ultrasonographic whirlpool sign in ovarian torsion. J Ultrasound Med. 2004;23:1643–9. - PubMed
    1. Van Voorhis BJ, Schwaiger J, Syrop CH, Chapler FK. Early diagnosis of ovarian torsion by color Doppler ultrasonography. Fertil Steril. 1992;58:215–7. - PubMed
    1. Berger RL, Robbins G. Torsion of normal ovary. Am J Surg. 1961;102:716–9. - PubMed
    1. Meyer JS, Harman CM, Harty MP, Markowitz RI, Hubba AM, Bellah RD. Ovarian torsion: Clinical and imaging presentation in children. J Pediatr Surg. 1995;30:1433–6. - PubMed

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