WOFAPS 2025 8th World Congress of Pediatric Surgery

Ceren Topsakal, Gül Şalcı, Hatice Sonay Yalçın Cömert, Mustafa İmamoğlu, Haluk Sarıhan

Karadeniz Technical University Faculty of Medicine Department of Pediatric Surgery

We aimed to investigate the efficacy of exosomes obtained from breast milk on the long-term effects of ischemia reperfusion injury due to testicular torsion. A total of 32 Sprague Dawley rats were divided into 4 equal groups. In Group 1 (control), a scrotal incision was made and closed without any other procedure. In Groups 2 (torsion), 3 (torsion+l) and 4 (torsion+s), the left testis was rotated 720 degrees clockwise and fixed; detorsion was performed 4 hours later. 1 cc of exosomes was administered locally to Group 3, and 1 cc of exosomes was administered intraperitoneally to Group 4 immediately after detorsion. Orchiectomy was performed 6 weeks after detorsion. In biochemical analysis, malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPX) levels were measured. Johnsen Testicular Biopsy Scoring (JTBS) was used to demonstrate the histopathological effect.

A significant difference was found between the groups in the evaluation of MDA enzyme (p=0.042). The MDA value of the torsion group was found higher than the control group (p=0.025). When the SOD value was compared between the groups, no significant difference was found (p=0.089). When the CAT value was compared between the groups, no significant difference was found (p=0.828). A significant difference was found between the groups in the evaluation of GPX enzyme (p=0.016). The GPX value of the torsion group was found significant compared to the control group (p1-2=0.019). The numerical decrease was found significant in the torsion+l group compared to the torsion group (p2-3=0.038). A significant difference was found between the groups in the JTBS evaluation (p<0.001). The numerical decrease was found significant between the control and torsion groups (p1-2= <0.001). A significant difference was found between the control and torsion+l groups (p1-3=0.004). The numerical difference between torsion and torsion+s groups was found to be significant (p2-4=0.003).

Our study is the first to investigate the long-term efficacy of breast milk exosomes in a testicular torsion model. All these results suggest that breast milk exosomes may be an effective therapeutic agent for patients with testicular torsion-detorsion.