Spermatic Vessel Ligation (Fowler-Stephens Maneuver): Experimental Results with Regard to Fertility

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Abstract
The effect of unilateral testicular infarction following torsion on contralateral testis spermatogenesis has been studied directly in rats and indirectly in man. Adverse effects on semen quality in humans and on testis biopsy in the experimental animal have been demonstrated. The spermatogenic function of normal contralateral testes following orchiopexy is known to be suboptimal. We studied the effects of transient testis ischemia produced by spermatic vessel ligation (the Fowler-Stephens maneuver) on spermatogenesis in the normal (contralateral) testis in mature Sprague-Dawley rats with spermatogenic activity determined in 10 days. Also, a group of prepubertal rats were operated upon and allowed to reach maturity to determine if prepubertal ischemia would result in any effect on the contralateral testis. Testis injury caused by acute ligation of the total testis blood supply does not cause morphological or spermatogenic changes in the contralateral testis. Ligation of the spermatic vessels may result in varying degrees of testicular injury. Often this injury is much greater histologically than one would expect from gross examination of the testis. However, the effects of this injury on the sperm production in the contralateral testis are negligible in rats and did not result in an iatrogenic decrease in fertility.