The role of different bacterial infections in the emergence of orchiepididymitis (experimental research)

The role of different bacterial infections in the emergence of orchiepididymitis (experimental research)

Alchinbaev M.K., Medeubekov U.S., Kusymzhanov S.M., Buyrashev A.K., Toktabayanov B.G., Aubakirova A.T.

JSC“The Research Center of Urology

named after B.U.Dzharbussinov”

Alchinbaev M.K. Doctor of Medical Sciences, Professor

Medeubekov U.S. Doctor of Medical Sciences

Kusymzhanov S.M. Doctor of Medical Sciences, Professor

Buirashev A.K. Doctor

Toktabayanov B.G. Doctor

Aubakirova A.T. Candidate of Biological Sciences

Abstract

The object of our research is the experimental animals (40 laboratory rats "Wistar" male, weight from 250 to 400 g), which was given a mixed bacterial culture injection into the parenchyma of the testes the, 0.2 mL (Streptococcus + staphylococcus in titer 10⁶). In the whole process of the research all animals were subjected to following procedures: ultrasonography, Doppler echosonography of gonadal vessels, histomorphological analysis.

Keywords: orchiepididymitis, experimental animals, ultrasonography, histomorphological analysis.

Introduction.One of the most common urological diseases in men is an acute inflammation of the epididymis, acute epididymitis, which is found both alone and in combination with acute inflammation of the testicle, as orchiepididymitis. Disease is spread in men mostly young and middle-aged belonging to the most socially active group of the population [1-2]. Up to 85% of patients are between the ages of 10 to 45 years [3-4]. In the structure of emergency urologic diseases patients with this pathology are 4,6-10,2% [5], and according to other authors [6], more than 25% of men throughout their lives tolerate various forms of epididymo-orchitis.

The problem of acute inflammatory diseases of the epididymis and testicular parenchyma has great social importance, as in 40-60% of patients in the outcome of the disease scar-sclerotic and atrophic changes develop in the testis, resulting in serious violations of the vas deferens patency its appendage, which results in a terrible complication as infertility. [7] Therefore, timely diagnosis and treatment orchiepididimitis is relevant.

About 40% of all observation among hospital infections is infection of the genitourinary tract. According to several authors, with the development of transurethral surgery the frequency of hospital orchiepididymitis increased to 6.5% [8]. After prostatectomy acute orchiepididymitis occurs in 5-6% of patients [9-10].

By now there are various etiological factors of acute inflammation of the testicle and the epididymis. According to many authors, causative agents of orchiepididymitis are bacterial flora, protozoa, saprophyte flora of male urethra, viruses, chlamydia, mycoplasma [11].

Aim - to determine the strains of probable bacterial culture and its dose for emergence of orchiepididymitis.

Materials and methods.As the object of the experiment white rats "Wistar" were chosen whose gonads have a relatively large size. In line with the objectives the experiment was carried out on 40 adult male rats with body weight from 250 to 400 g.

Nonspecific bacterial cultures were taken by us in the bacterial laboratory of JSC “The Research Center of Urology named after B.U.Dzharbussinov” for modeling of chronic orchiepididymitis in the experiment, considering their adhesive properties, staphylococcus, streptococcus in titer ¹⁰⁶microbial cells and mixed culture of the streptococcus +staphylococcus in titer of 10⁶.

The experimental animals were divided into 4 groups:

The first group included 10 animals, 5 of them were gave an injection with insulin syringe of staphylococcus culture to a depth of 3 mm in titer 10⁶microbial cells of 0.1 ml, the other 5 - of 0.2 ml.

The second group consists of 10 rats, 5 of them were gave an injection with insulin syringe of streptococcus culture to a depth of 3 mm in titer 10⁶microbial cells of 0.1 ml, the other 5 - of 0.2 ml.

The third group consists of 10 animals, 5 of them were gave an injection with insulin syringe of streptococcus+ staphylococcus mixed culture to a depth of 3 mm in titer 10⁶microbial cells of 0.1 ml, the other 5 - of 0.2 ml.

A fourth group is the control group that consists of 10 animals, which gave an injection of 0.9% of saline.

The operating fields (testes) were pretreated with 70% Chlorhexidine-Alcohol Solution.

$C:\Documents and Settings\User\Рабочий стол\Врачи\АСЕТ\НАУКА\Крыса\эксперимент фото\SAM_0225.JPG$ $C:\Documents and Settings\User\Рабочий стол\Врачи\АСЕТ\НАУКА\Крыса\эксперимент фото\SAM_0226.JPG$

Pictures 1, 2 – the injection of bacterial culture into the parenchyma of the testicle.

The experimental animals were kept in the same conditions of normal vivarious regime with mixed lighting. Feeding made twice a day in accordance with established standards, water supply is not limited. Animals were placed in plastic cages, no more than two rats in each one.

$C:\Documents and Settings\User\Рабочий стол\Врачи\АСЕТ\НАУКА\Наука фото\050120121128.jpg$ Ultrasonography of the testes was performed for all animals on the machine General Electric Loqic5 Expert with surface sensor at 8-10MHz.

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Pictures 3, 4 – Ultrasonography of the rats` testes.

The results of research.

Table 1 - Dynamics of changes of body temperature in rats

Group	Before the injection	Day 3	Day 7	Day 15	Day 30
I	38,5±0,06	39,4±0,07	38,9±0,04	38,7±0,02	38,4±0,05
II	38,4±0,05*	40,9±0,04	39,0±0,02	38,7±0,03	38,5±0,02
III	38,3±0,04**	40,9±0,04**	40,8±0,03	38,8±0,02	38,2±0,04
IV	38,4±0,02	38,5±0,05	38,5±0,04	38,5±0,03	38,6±0,02

**р≤0,02comparing with the control group

* р≤0,04 comparing with 1,2 groups

Analyzing the data in Table 1, you can see that in the 3 group there was a significant increase of body temperature in experimental animals compared with the controlgroup, and 1, 2 groups.

On day 4 after injection of bacterial cultures one experimental animalwhich was injected 0.2 ml of mixed flora in testis, died. There was made a sampling of testes along withepididymis in order to do morphological study.There were clinical and local manifestations of orchiepididymitis among others animals.

Table2 - Dynamics of changes in the size of the testes in rats

Group	Before the injection	Day 3	Day 7	Day 15	Day 30
I	19,8±1,4	21,4±1,3	20,7±0,5	20,0±0,9	19,7±1,2
II	20,8±0,9	22,5±0,6*	23,1±1,4	21,9±1,1	20,5±0,9
III	20,4±0,4	24,8±1,3**	26,1±0,4**	23,9±0,9	23,2±0,7
IV	20,9±1,5	20,4±1,3	20,5±0,5	20,7±0,3	20,4±0,7

**р≤0,04comparing with the control group

* р≤0,03 comparing with 1,2 groups

Table3 - Dynamics of changes in weight in rats

Group	Before the injection	Day 3	Day 7	Day 15	Day 30
I	325±10	315±12	302±10	299±12	390±11
II	330±15	311±12*	306±11	295±13	293±12
III	328±19	288±14**	274±13**	261±15	259±12
IV	335±16	340±25	337±21	333±20	335±20

**р≤0,03comparing with the control group

* р≤0,05comparingwith 1,2 groups

Ultrasonographyof gonads of experimental animalswas carried out on3,7,15,30 day,in which ultrasound signs of orchiepididymitis was marked. The most expressed changes in the parenchyma of the testes have been identified in group III, who received a mixed culture (Streptococcus Staphylococcus + ¹⁰⁶) in a volume of 0.2 ml. Ultrasoundpicturewascharacterizedbythefollowingfeatures:

Day 3: Increase of the size of the testicle by 3-5 mm, the hypoechoinclusions (2-4mm), indicating the presence the inflammatory process in the testis, have been detected in the structure

Day 7: Increase of the size of the testicle by 5-7 mm, the small multiple hypoechoinclusions have been detected in the structure, testicular vascular pattern is strengthened, the number of visible vessels is increased.

Day 15: testicle still has its former dimensions, the isolated hypoechoinclusions have been detected in the structure, and isolated small areas of seals (1-2 mm) have been detected.

Day 30: the dimensions of testicle are normal, the areas of increased density (size from 3-9 mm) have been detected in the structure, ultrasonography showed that blood flow in the seal area is significantly reduced, noted the depletion and deformation of vascular pattern of the area of fibrosis,blood flow velocity is reduced in comparison with the control group.

Pictures 5, 6 – Ultrasound picture of rats` testes of the group III.

Thus, the most optimal bacterial culture for an experimental orhoepididimitis is a mixed flora - Streptococcus+ Staphylococcus in titer ¹⁰⁶.This is proved by clinical and instrumental data.

List of literature

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2. Абоев З.А. Ультразвуковая диагностика острых заболеваний органов мошонки// Андрология и генитальная хирургия. 2001. - №4. - С. 84-87

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Acknowledgements.

Our special thanks to the staff of The Research Center of Urology named after B.U.Dzharbusynov and the staff of vivarium of Kazakh National Agrarian University.