Recovery of spermatogenesis after microsurgical subinguinal varicocele repair in azoospermic men based on testicular histology



Título del documento: Recovery of spermatogenesis after microsurgical subinguinal varicocele repair in azoospermic men based on testicular histology
Revue: International braz j urol
Base de datos: PERIÓDICA
Número de sistema: 000296741
ISSN: 1677-5538
Autores: 1
2
Instituciones: 1ANDROFERT-Centro de Referencia em Reproducao Masculina, Campinas, Sao Paulo. Brasil
2Hospital Ipiranga, Departamento de Urologia, Sao Paulo. Brasil
Año:
Periodo: Nov-Dic
Volumen: 31
Número: 6
Paginación: 541-548
País: Brasil
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Caso clínico, analítico
Resumen en inglés OBJECTIVE: Analyze whether testicular histologic patterns from a group of azoospermic men with varicocele is predictive of treatment outcome after subinguinal microsurgical varicocele repair. MATERIALS AND METHODS: Seventeen azoospermic men underwent bilateral open single testis biopsy and microsurgical subinguinal repair of clinical varicoceles. RESULTS: Histopathology of testicular biopsies revealed hypospermatogenesis (HYPO) in 6 men, maturation arrest (MA) in 5, and Sertoli cell-only (SCO) in 6. Overall, presence of spermatozoa in the ejaculates was achieved in 47% (8/17) of men after varicocele repair, but only 35% (6/17) of them had motile sperm in their ejaculates. Only men with testicular histology revealing HYPO (5/6) or maturation arrest (3/5) had improvement after surgery. Median (25% - 75% percentile) postoperative motile sperm count for both groups were 0.9 X 106/mL (0.1-1.8 X 106/mL) and 0.7 X 106/mL (0.1-1.1), respectively (p = 0.87). The mean time for appearance of spermatozoa in the ejaculates was 5 months (3 to 9 months). One (HYPO) of 8 (12.5%) men who improved after surgery contributed to an unassisted pregnancy. Postoperative testicular biopsies obtained from patients who had no improvement after surgery revealed that testicular histology diagnosis remained unchanged. Successful testicular sperm retrieval for intracytoplasmic sperm injection (ICSI) was achieved in 4 of 9 (44.4%) individuals who did not improve after surgery, including 1 man with testicular histology exhibiting SCO. CONCLUSION: Microsurgical var
Disciplinas: Medicina
Palabras clave: Cirugía,
Varicocele,
Azoospermia,
Microcirugía,
Testículos,
Histología
Keyword: Medicine,
Surgery,
Varicocele,
Azoospermia,
Microsurgery,
Testis,
Histology
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