Conventional Versus Microdissection Testicular Sperm Extraction for Nonobstructive Azoospermia

Abstract

In nonobstructive cases, especially those of the Sertoli-cell-only syndrome, microdissection TESE can effectively retrieve spermatozoa and minimize the risk of complications.

Microdissection testicular sperm extraction: Prediction, outcome, and complications

“…Patients diagnosed with hypospermatogenesis by histological examination should have obtainable testicular sperm. 40 35 They also reported that SRRs by microdissection TESE for maturation arrest and SCO were 75% and 33.9%, respectively, whereas those by conventional TESE were 37.5%, and 6.3%. 35 Recently, Ramasamy et al reported the outcomes of 460 patients with NOA treated with microdissection TESE.…”

“…40 35 They also reported that SRRs by microdissection TESE for maturation arrest and SCO were 75% and 33.9%, respectively, whereas those by conventional TESE were 37.5%, and 6.3%. 35 Recently, Ramasamy et al reported the outcomes of 460 patients with NOA treated with microdissection TESE. 36 In that report, the SRR by microdissection TESE was 57%, whereas that by conventional TESE was 32%.…”

“…The outcome of microdissection TESE has been reported (Table 1). 30,31,[33][34][35][36] In 1999, Schlegel reported the excellent outcome of microdissection TESE. In that report, the sperm retrieval rate (SRR) was 63% by microdissection TESE compared to 45% by conventional TESE.…”

“…36 Okada et al reported that a postoperative decrease in the serum TT concentration was observed in two patients who underwent conventional TESE, whereas none occurred in the microdissection group. 35 Hypogonadism developed in one patient who underwent conventional TESE due to ischemic atrophy of the testes. 35 A recent large-scale comparative study showed that serum TT levels dropped to 80% of pre-TESE levels in both the conventional and microdissection groups at 3-6 months after the procedure and that the levels rose back to 85% after 12 months and to 95% after 18 months.…”

“…35 Hypogonadism developed in one patient who underwent conventional TESE due to ischemic atrophy of the testes. 35 A recent large-scale comparative study showed that serum TT levels dropped to 80% of pre-TESE levels in both the conventional and microdissection groups at 3-6 months after the procedure and that the levels rose back to 85% after 12 months and to 95% after 18 months. 36 Another study reported that microdissection TESE is associated with a significant long-term decrease in serum TT level.…”