Pathophysiology and impact of testicular torsion/detorsion on male reproduction: Therapeutic approach with some phytochemicals.

Testicular torsion is a typical urologic emergency that occurs when the spermatic cord twists and impairs blood flow to the testicles. It results in hypoxia, oxidative stress, inflammation, and ultimately fetal harm and apoptosis. It takes a pathologist's quick diagnosis and surgical action to save fetal function. Reperfusion following extended ischemia exacerbates inflammation and oxidative damage, making germ-cell apoptosis more difficult. Several complicated signaling pathways, including neutrophil activation, endothelial dysfunction, cytokine release, and stress-related gene expression, contribute to germ cell death, followed by subfertility or sterility. Many phytochemicals have shown promising potential in experimental models to counteract some pathophysiological mechanisms. This article reviews the complex pathophysiology caused by reflow, the resulting disruption of the hypothalamic-pituitary-gonadal axis, and the adverse effects on male fertility. The therapeutic implications of some bioactive phytochemicals as potential contributors to preserving testicular viability are also discussed to explore their roles. They determine the scope for well-designed clinical research. This may pave the way for combination therapy to improve outcomes and preserve fertility in cases of testicular torsion.