Anti-Oxidant and Selective Cyclooxygenase 2 Inhibitor Combination in a Rat Testicular Torsion Model: Does it Really Work?

Purpose

To investigate whether the combination treatment of an anti-oxidant (L-carnitine) and a selective cyclooxygenase-2 (COX-2) inhibitor (meloxicam) is effective in the treatment of cellular damage caused by testicular torsion.

Material and Methods

30 male wistar rats were randomly divided into 4 groups. Control group composed of sham operation and second group underwent torsion/detorsion for 90minutes. Group 3 and 4 received L-carnitine (500mg/kg/day) and meloxicam (3mg/kg/day), respectively in addition to the same torsion/detorsion procedure. Group 5 was subjected to the maximum treatment with L-carnitine and meloxicam after torsion/detorsion. Bilateral orchiectomy was performed 96hours after the operation in all groups. Histopathologic analysis was performed according to Cosentino's classification system. In addition, catalase (CAT), Malondialdehyde (MDA) and Lipid hydroperoxidase (LHP) activities were biochemically measured in the testes.

Results

L-carnitine, meloxicam and combination therapy resulted in a statistically significant decrease in MDA activity in unilateral testicular torsion/detorsion model (p:0.002, p:0.02 and p:0.041). Although statistically insignificant, CAT activity increased after meloxicam treatment (p:0.24) and LPH activity decreased after L-Carnitine treatment (p:0.065). In addition, treatment with L-carnitine caused a significant decrease in Cosentino grade compared to group 2 (p:0.037).

Conclusions

The results of this study have shown that L-carnitine has definite beneficial effects on cellular damage after testicular torsion/detorsion probably through its well known anti-oxidant effects. Although unequally effective, selective cyclooxygenase inhibition seems to exert its anti-inflamatory effects through inhibition of cytokine release in response to torsion. So, combination therapy of these agents might be chosen for the most reproductive treatment of testicular torsion at cellular level.

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