Abstract

Nowadays tramadol misused and abused is wide spread mainly among young and middle-aged people, especially males as it used in management of premature ejaculation and for orgasm extension. However, these patients are susceptible to many problems after long term administration of tramadol including histological changes on testis. This study is designed to study the effect of tramadol on the histological change of testis and its withdrawal effect with the possibility of vitamin C to reverse these changes. Fifty adult male albino rats were used in this study. Animals were divided into five equal groups: Group A (control group), rats were injected with distilled water. Group B (treated with tramadol only)(TGI), rats were injected with   tramadol (50mg/kg b.wt.). Group C (treated with tramadol + vitamin C) (TGII), rats  were injected with vitamin C (100mg/Kg/b.wt.) half hour prior to tramadol injection in the same dose  as in TGI.  These animals were injected intraperitoneally (I.P.) for 4 wks. Group D (treated group B withdrawal) (TGI WD), rats treated as group B then left for two wks. as withdrawal group. Group E (treated group C withdrawal) (TGII WD), rats treated as group C then left for two wks. as withdrawal group. At the end of the experiment, the rats were killed and testis was removed and preserved in a fixative and processed to get paraffin wax block and prepared for microscopic examination. The results showed histological changes in the tramadol treated rats were irregularity and atrophy of S.T. with widening of the interstitisum along with arrest of spermatogenesis at level of spermatid in most of seminiferous tubules (S.T.) while in others it arrested at level of spermatocyte with exfoliated germinal epithelium in the lumens of most tubules. Vacuoles are present in cytoplasm of spermatocytes with detachment of degenerated germinal epithelial cells from basement membrane, the interstitisum has been shown vacuolated homogenous acidophilic material. After adding of vitamin C in Group C (TGII), the histological findings have been shown improvement in the histological structure of testis. In both withdrawal groups (Group D &E), there were signs of improvement in the S.T. mainly in group E that appeared somewhat like normal. This study was concluded that tramadol caused structural changes in testicular tissues with poor reversibility following withdrawal but adding vitamin C has role in alleviated the histological changes and accelerated the reversibility.