Histological study of the removed testes of patients after acute monolateral spermatic cord torsion.

Infertility is frequent in patients after spermatic cord torsion usually when the twisted testis is not removed and becomes atrophic. The mechanism seems to be autoimmune. To see if the atrophic testis may be the source of antigens we carefully examined the histology of atrophic testis of 6 patients. The two patients that had spermatic cord torsion more than 3 years before surgical removal did not show recognizable testicular structures while the other patients that had spermatic cord torsion less than 1 year still showed some spermatogonia in the tubules and some spermatozoa in the epididymis. We think that the surgical removal of the atrophic testis after more than 1 year from the acute episode is of doubtful utility for preventing or blocking the autoimmune phenomenon because testicular antigens are absent and the autoimmune mechanism is able to maintain itself.