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Oral Presentation - 65
THE EFFECTS OF INTRAABDOMINAL PRESSURE INCREASE DURING LAPAROSCOPY IN MALE RATS ON FERTILITY
L Sapan, M İmamoğlu, A Alperen, A Calapoğlu, S Samut, H Sarıhan
Karadeniz Technical University, Faculty of Medicine, Department of Pediatric Surgery, Trabzon
Backround: In clinical and experimental studies, it is shown that laparoscopy leads to ischemia and reperfusion injury in intraabdominal organs. Testes is one of the organs mostly affected by increased intraabdominal pressure (IAP). In our experimental study, we investigated that influence on fertility in male rats during performing laparoscopy due to IAP.
Methods: 24 male rats were divided into 3 groups. Group A assigned to rats without undergone pneumoperitoneum. In group B and group C pneumoperitoneum occurs under 10 mmHg and 20 mmHg IAP, respectively. IAP was sustained using otomatically working laparoflator resulting pnömoperitoneum. At group B and group C pnömoperitoneum was maintained for 60 minutes and then laparoscopy was completed by desuflation. 6 weeks after laparoscopy, right and left testes of all rats where removed. Germ-cell assesment was done using histologically testes biopsy scoring (TBS) and testes injury grading. Persentage of apaptosis was eveluated by method of flow citometry. All results were analysed statistically.
Results: In assessment of testes injury grading, we obtained Grade I, Grade II and Grade III for Group A, Group B and Group C respectively. As a result, we found that testes injury grading increases with IAP. For germ cell evulation in testes biopsy, we obtained TBS. TBS 9-10 for Group A, TBS 9-8-7 for Group B, TBS 8-7-6-5-4 for Group C. Consequently, we conculed that TBS scoring is decreased with IAP, germ cell injury is increased with IAP and spermatogenesis was impaired with IAP. In assesment of testes tissue apoptosis, we obtained apoptosis %4.4 for Group A, % 22.4 for Group B and %31.0 for Group C. We concluded that apoptosis increased in testes with IAP and spermatogenesis was impaired with IAP.
Conclusions: We observed that IAP which is performed for laparoscopic operation leads to degeneration histologically in testicular tissue, regarding as proportional to pressure level. We obtained that resultant degeneration and severe germ cell injury mostly occurs in 20 mmHg IAP.