Testicular histology after transparenchymal fixation using polytetrefluoroethylene suture: an animal model

The optimal surgical technique for orchiopexy is controversial. Studies have shown that adequate fixation can be obtained using a subdartos pouch alone; however, transparenchymal suture fixation with a permanent suture frequently is used to provide additional security and for the treatment and prevention of testicular torsion. In previous studies, the suture has been placed through the tunica albuginea. This could have a detrimental effect on future spermatogenesis. Polypropylene has been shown to have the least histological change and is considered to be the suture of choice. However, polypropylene is a stiff suture and can be disconcerting for the patient when left in place. Polytetrafluoroethylene (PTFE) is a soft, permanent suture used widely in vascular surgery because of its handling characteristics. In this study, the authors compare the histological changes caused by PTFE and polypropylene.

Bilateral orchiopexies were performed in 36 Sprague-Dawley rats. All rats were 27 to 31 days old and weighed 75 to 100 g at the time of orchiopexy. The animals were divided into 3 groups receiving polypropylene and PTFE, silk and PTFE, or polypropylene and silk. After 30 days, all rats were killed, and the testes were harvested. The testes were step sectioned and examined for histological changes. These changes were graded by a pathologist in a blinded fashion.

The data obtained were statistically analyzed. The superficial histological changes associated with transparenchymal fixation by polypropylene, PTFE, and silk were significantly different, but the parenchymal changes were not.

PTFE causes no greater histological change than polypropylene. In light of the PTFE's softness and superior handling characteristics, the authors recommend the use of PTFE when a permanent suture is used in orchiopexy.