The Predictive Value of Ischemia-modified Albumin in Long-term Results of Ischemia-reperfusion Injury in an Experimental Testicular Torsion Model

OBJECTIVE To establish the value of ischemia-modified albumin levels in the determination of the long-term results of testicular torsion/detorsion-associated ischemia-reperfusion injury. METHODS Eighteen mature male Wistar rats were divided randomly into 3 groups (n = 6 for each group): control, acute torsion/detorsion (T/D) group, and long-term T/D. In the control group, scrotal incision only was performed; in the acute T/D group, after 4 hours of torsion, detorsion was performed and maintained for 2 hours. Blood samples and testicular tissue samples were taken after 2 hours of detorsion. The same T/D procedures were performed in the long-term T/D group. The long-term T/D groups were kept alive for 2 months, and samples were taken at 2 months post procedure. Serum ischemia-modified albumin, serum and tissue malondialdehyde levels, and histopathological damage scores were measured. RESULTS Serum ischemia-modified albumin levels were significantly higher compared with the control group, in the acute-term T/D (P = .004). This elevation remained pronounced in the long term compared with the control group and acute period (P = .008 and P = .017, respectively). There was a significant negative correlation between serum ischemia-modified albumin levels and histopathological injury score in both the torsioned and contralateral testes (r = -.929, P < .0001 and r = -.560, P = .02, respectively). CONCLUSION Ischemia-modified albumin is a valuable parameter in terms of reflecting testis injury in testicular torsion in both the acute period and the long term. It therefore has the potential to be used as data with predictive value regarding patients' fertility capacities. UROLOGY 80: 689-694, 2012. (c) 2012 Elsevier Inc.