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Original Research

To Spare or not to Spare? Bladder Neck and Robotic Radical Prostatectomy


1 Kayseri Şehir Hastanesi, Üroloji Kliniği, Kayseri
2 Koç Üniversitesi, Tıp Fakültesi, Üroloji Anabilim Dalı, İstanbul
 


DOI : 10.33719/yud.488845
New J Urol. 2019; 14 (3): 144-151

Abstract

Objective: We aimed to present the results of unilateral microscopic testicular sperm extraction (mTESE) in non-obstructive azoospermia (NOA) cases in our clinic and to elucidate the factors affec- ting mTESE success.
 

Materials and Methods: Our study was pros- pectively designed and 102 NOA patients were included. Testis volumes, serum follicle stimulating hormone (FSH), luteinizing hormone (LH), prolac- tin (PRL) and testosterone (T) levels were measured and genetic evaluations was carried out. We perfor- med mTESE and divided patients into two groups according to sperm extraction results as mTESE is successful (sperm could be found) or failed (sperm could not be found). The two groups were compa- red in demographic, clinical and histopathological data.
 

Results: Sperm extraction by mTESE was suc- cessful in 64 (62.7%) patients. There was no signifi- cant difference between two groups in terms of age, infertility times, serum T and PRL levels (p=0.896, p=0.357, p=0.504, p=0.179, respectively). Serum FSH and LH levels were significantly lower, and the mean testis volume was significantly higher in the group that micro-TESE was successful (p=0.004, p=0.001, p=0.029, respectively). Histopathological evaluation revealed a significant difference betwe- en hypospermatogenesis, sertoli cell only syndro- me (SCOS) and maturation arrest (MA) groups in terms of mTESE success (88.5%, 37.5%, 30%, res- pectively; p<0.001).
 

Conclusion: Our unilateral mTESE success rate was similar to those performed bilaterally in literature. Besides the multiple predictive factors of mTESE success rate, unilaterally performed mTESE is less invasive procedure preserving the integrity of the contralateral testis and may be advantageous in terms of improving salvage mTESE results.
 

Keywords: Non-obstructive azoospermia, Micro-TESE, Sperm retrieval, Unilateral.


Abstract

Objective: We aimed to present the results of unilateral microscopic testicular sperm extraction (mTESE) in non-obstructive azoospermia (NOA) cases in our clinic and to elucidate the factors affec- ting mTESE success.
 

Materials and Methods: Our study was pros- pectively designed and 102 NOA patients were included. Testis volumes, serum follicle stimulating hormone (FSH), luteinizing hormone (LH), prolac- tin (PRL) and testosterone (T) levels were measured and genetic evaluations was carried out. We perfor- med mTESE and divided patients into two groups according to sperm extraction results as mTESE is successful (sperm could be found) or failed (sperm could not be found). The two groups were compa- red in demographic, clinical and histopathological data.
 

Results: Sperm extraction by mTESE was suc- cessful in 64 (62.7%) patients. There was no signifi- cant difference between two groups in terms of age, infertility times, serum T and PRL levels (p=0.896, p=0.357, p=0.504, p=0.179, respectively). Serum FSH and LH levels were significantly lower, and the mean testis volume was significantly higher in the group that micro-TESE was successful (p=0.004, p=0.001, p=0.029, respectively). Histopathological evaluation revealed a significant difference betwe- en hypospermatogenesis, sertoli cell only syndro- me (SCOS) and maturation arrest (MA) groups in terms of mTESE success (88.5%, 37.5%, 30%, res- pectively; p<0.001).
 

Conclusion: Our unilateral mTESE success rate was similar to those performed bilaterally in literature. Besides the multiple predictive factors of mTESE success rate, unilaterally performed mTESE is less invasive procedure preserving the integrity of the contralateral testis and may be advantageous in terms of improving salvage mTESE results.
 

Keywords: Non-obstructive azoospermia, Micro-TESE, Sperm retrieval, Unilateral.