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Neurodegenerative consequences of electrocautery-assisted circumcision on spermatogenesis: A stereological
Binali Firinci1, Çetin Aydin1, Dilek Yunluel1
1Department of Pediatric Surgery, Medical Faculty of Ataturk University, Erzurum, Turkey.
Background:
Despite being a widely practiced and debated procedure for centuries, the impact of different circumcision techniques on spermatogenesis remains insufficiently explored. This study investigates the potential effects of conventional surgical and monopolar electrocautery-assisted circumcision methods on spermatogenesis.
Methods:
The study was conducted on 18-month-old male New Zealand rabbits, divided into 3 groups: a control group (Group I, n = 5), a surgical circumcision group without electrocautery (Group II, n = 5), and a monopolar electrocautery group (Group III, n = 8), with a total of 18 animals. All procedures were performed under general anesthesia. The animals were monitored for 3 weeks before being sacrificed. Stereological analysis was used to evaluate Onuf nucleus, pudendal ganglia, and sperm counts. Histopathological analyses were performed on the affected tissues to evaluate structural and cellular changes.
Results:
Degenerative changes were observed in the dorsal penile fibers of the pudendal nerves, the pudendal ganglia, and Onuf nucleus. The density of degenerative neurons (n/mm³) in Onuf nucleus and pudendal ganglia, along with sperm counts, were as follows: Group I: 4 ± 1, 9 ± 3, and 96,891 ± 11,893, respectively; Group II: 11 ± 4, 154 ± 45, and 93,156 ± 8365; Group III: 121 ± 34, 2121 ± 318, and 76,783 ± 4956. The P-values for comparisons were as follows: Group I versus Group II, P < .005; Group II versus Group III, P < .0005; and Group I versus Group III, P < .00001.
Conclusion:
The use of monopolar electrocautery during circumcision may be associated with neurodegenerative changes that originate at the distal pudendal nerve endings and extend retrogradely to the pudendal ganglia and Onuf nucleus. These changes may disrupt testicular innervation and could potentially contribute to reduced sperm production.
