Amaç: Bu çalışmanın amacı obstruktif olmayan azospermisi (OOA) olan hastalarda varikoselektominin spermatogeneze etkisini incelemek ve respermatogenezi öngören klinik faktörlerin varlığını araştırmaktır. Gereç ve Yöntem: Klinik anlamlı varikosel saptanarak infertilite tanısı alan 32 hasta çalışmaya dahil edildi. Bütün hastalara mikrocerrahi inguinal varikoselektomi ve aynı seansta testis biyopsisi uygulandı. Postoperatif 3, 6 ve 12. aylarda hastaların spermiyogram kontrolleri yapıldı. Yaş, testis hacmi, hormon parametreleri ve patolojik bulguların operasyon sonrası sperm üretimini öngörmede etkinliği araştırıldı. Bulgular: Hastaların cerrahi zamanındaki ortalama yaşı 31,4±6,2 idi. Varikoselektomi sonrası hastaların %15,6 (5/32)'sinde spermiyogram ile sperm varlığı tespit edildi. Patolojik değerlendirme sonucunda sırasıyla %34,4, %31,2 ve %34,4 oranlarında hipospermatogenez, matürasyon arresti ve germ hücre aplazisi tespit edildi. Re-spermatogenez saptanan hastaların testis hacimleri daha büyüktü (p=0.01). Re-spermatogenez saptanan ve saptanmayan hastalar arasında araştırılan diğer parametreler açısından istatistiksel anlamlı fark yoktu. Sonuç: Varikoselektomi, klinik olarak anlamlı varikoseli olmayan OOA olan hastalarda kabul edilebilir bir tedavi yöntemidir. Diğer taraftan doğru hasta profilinin seçimi çok önemlidir. Bu çalışmada varikoselektomi sonrası spermatogenezin öngörülmesinde testis hacminin prediktif değeri gösterilmiştir. Anahtar Kelimeler: İnfertilite, Obstruktif olmayan azospermi, Varikoselektomi Öz Objective: The aim of this study was to investigate the effect of varicocelectomy on spermatogenesis in patients with non-obstructive azoospermia (NOA) and the presence of clinical factors for re-spermatogenesis. Materials and Methods: A total of 32 patients with clinically significant varicocele, who received the diagnosis of infertility, were included in this study. Microsurgical inguinal varicocelectomy and testicular biopsy were performed in all patients. After varicocelectomy, control spermiogram samples were collected from patients at 3 rd , 6 th and 12 th months. The role of age, testicular volume, hormone parameters and pathological findings in predicting re-spermatogenesis were investigated. Results: The mean age of the patients who underwent surgery was 31.4±6.2 years. After varicocelectomy, sperm was detected in semen in 15.6% (5/32) of the patients. As a result of pathological evaluation, hypospermatogenesis, maturation arrest and germ cell aplasia were found in 34.4%, 31.2% and 34.4% of patients, respectively. The testicular volume was higher in patients with re-spermatogenesis (p=0,01). There was no statistically significant difference between responders and non-responders in terms of other investigated parameters. Conclusion: Varicocelectomy is an acceptable modality of treatment for patients with NOA with clinically significant varicocele. On the other hand, appropriate patient selection is crucial. In this study, testicular volume was found to be a predictive factor for recovery of sperma...
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