The effect of acute cold ischemia duration on testicular tissue

Purpose Testicular cancer primarily affects men aged 15–34. Partial orchiectomy has recently emerged as a viable testis-sparing surgical technique. However, prolonged spermatic cord clamping may induce ischemia-reperfusion (I/R) injury due to elevated reactive oxygen species (ROS) production. This study aimed to evaluate the protective role of testicular hypothermia against I/R injury and to determine the maximum tolerable cold ischemia duration in a rat model. Spermatogenesis was assessed using the Johnsen scoring system. Materials and Methods Thirty sexually mature Wistar albino rats were divided into four groups. Following scrotal incision and testicular cooling with ice (2–4°C), Group I (Sham, n = 6) underwent orchiectomy. Groups II, III, and IV (n = 8 each) were subjected to 10, 20, and 30 minutes of ischemia, respectively, followed by 1-hour reperfusion. Biochemical parameters (TNF-α, IL-6, TAS, TOS, OSI) and histopathological evaluations, including Johnsen scoring, were conducted. Results Inflammatory markers and oxidative stress indices increased significantly with prolonged ischemia, while antioxidant capacity and Johnsen scores declined in a time-dependent manner. The most severe biochemical and histological impairments were observed in the 30-minute group. Conclusion Cold ischemia exceeding 20 minutes leads to marked testicular damage, despite hypothermic protection. Findings emphasize the need to minimize ischemic duration during testis-sparing surgeries.