Table 3: Treatments that improve and/or prevent testicular and sperm damage in experimental testicular torsion.

TreatmentMechanismResults versus injuryReference

Transplanted endotelial progenitor cells N/A
Prevents histopathological damage
Pretreatment w/ginkgo biloba (EGb 761)
Extract of dried leavesPrevents histopathological damage
Apoptosis, eNOS mark
▲ Mean seminiferous tubule diameter
Pretreatment w/sildenafil citrate (0.7 mg/kg)
type 5 inhibitor
MDA levels and eosinophil counts
Prevents histopathological damage
▲ GSH, PON1, NO, and blood lymphocyte counts in plasma
Pretreatment w/sildenafil citrate (1.4 mg/kg)Phosphodiesterase
type 5 inhibitor
MDA levels
▲ PON1, vitamin E, β-carotene in plasma, and GSH levels
Pretreatment w/melanocortin 4 activatorMelanocortin analog IL-6 and TNF-α, Bax
▲ Bcl-2 expression, Johnsen's spermatogenesis score
RutinAntioxidant MDA levels
▲ SOD and CAT activities, Johnsen's spermatogenesis score
Gradual detorsionN/A▲ SOD and GPx activities[53]
MolsidomineNitric oxide donor MDA levels and Cosentino's score
▲ Sonic hedgehog and HIF1-α expression
Cyclosporine and FK-506Immunophilin ligands MDA levels, apoptosis
▲ CAT, SOD, and Gpx activities
Pretreatment w/trapidilVasodilatorPrevent histopathological damage[56]
HeminIron-containing porphyrin NF- kappaB and ERK levels
▲ heme oxygenase-1
Pretreatment w/ethyl pyruvateAntioxidant,
MDA, myeloperoxidase levels and apoptotic index
▲ CAT, GSH, Gpx, SOD activities and sperm count and motility
Pretreatment w/losartan, lisinoprilAngiotensin II receptor antagonist, ACE inhibitorPrevents histopathological damage in contralateral testis[59]

ROS: reactive oxygen species; GSH: glutathione; SOD: superoxide dismutase; eNOS: endothelial nitric oxide synthetase; MDA: malondialdehyde; CHOP: C/EBP homology protein; CREMτ: cAMP-responsive element modulator-τ; MCP: monocyte chemotactic protein-1; N/A: not available.