Salvage microdissection testicular sperm extraction after failed conventional testicular sperm extraction in patients with nonobstructive azoospermia
Salvage microdissection testicular sperm extraction after failed conventional testicular sperm extraction in patients with nonobstructive azoospermia
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DOI：
10.1016/s0022-5347(05)00678-6
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发表时间：
2006-04-01
影响因子：
6.6
通讯作者：
Okuyama, A
中科院分区：
文献类型：
--
作者：
Tsujimura, A;Miyagawa, Y;Okuyama, A
目的：TESE被认为是识别精子回收小管的最佳方法。该技术将SRR提高到50%左右。然而，尚不清楚它是否对传统TESE失败的患者有用。我们比较了常规TESE失败的患者和未接受常规TESE的患者的显微切割TESE结果。我们还评估了抢救性显微切割TESE的结果和以前的传统TESES.Materials和方法的特点之间的关系：共46例非梗阻性无精子症，其中抢救性显微切割TESE失败后，常规TESE进行。患者的特点和SRR进行了比较，这些患者和134人，其中传统的TESE没有进行过。以前的TESE程序，睾丸组织学和TESE之间的间隔也evaluated.Results：患者的特点并没有显着差异组之间。显微切割TESE SRR在两组之间也没有显著差异（45.7% vs 44.0%）。无论以前任何其他TESE手术失败与否，也无论睾丸组织学如何，通过挽救性显微切割TESE成功回收精子的可能性仍然存在。挽救性显微切割TESE SRR是不相关的TESEs.Conclusions之间的时间间隔：因为挽救性显微切割TESE是有效的，在传统的TESE已经失败的患者，这种选择应提供给他们的理解，延长随访后挽救性显微切割TESE是必要的，由于性腺功能减退症的风险。
Purpose: TESE is considered the best procedure for identifying a tubule for spermatozoa retrieval. This technique improves the SRR to around 50%. However, it has been unclear whether it is useful in patients in whom conventional TESE has failed. We compared the outcome of microdissection TESE in patients in whom conventional TESE failed to that in patients who did not undergo conventional TESE. We also evaluated relations between the outcome of salvage microdissection TESE and the characteristics of previous conventional TESE.Materials and Methods: A total of 46 patients with nonobstructive azoospermia in whom salvage microdissection TESE was performed after failed conventional TESE were included. Patient characteristics and the SRR were compared between these patients and 134 in whom conventional TESE had not been performed previously. The previous TESE procedure, testicular histology and interval between TESEs were also evaluated.Results: Patient characteristics did not differ significantly between the groups. The microdissection TESE SRR also did not differ significantly between the groups (45.7% vs 44.0%). The possibility of successful spermatozoa retrieval by salvage microdissection TESE remained regardless of the previous failure of any other TESE procedure and regardless of testicular histology. The salvage microdissection TESE SRR was not related to the interval between TESEs.Conclusions: Because salvage microdissection TESE is effective in patients in whom conventional TESE has failed, this option should be made available to them with the understanding that extended followup after salvage microdissection TESE is necessary due to the risk of hypogonadism.