Open testicular mapping: A less invasive multiple biopsy approach for testicular sperm extraction

Vieira, Marcelo; Glina, Felipe Placo Araujo; Mizrahi, Françoise Elia; Mierzwa, Tiago César; Glina, Sidney

doi:10.1111/and.13547

Cited by 4 publications

(6 citation statements)

References 25 publications

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“…If no spermatozoa are found in the first testis, the contralateral testicle is approached the same way. This study demonstrated that using an approach with multiple small biopsies, it was possible to retrieve sperm in 54% of patients in the study with NOA, in addition to demonstrating that FSH levels and testicular volume were not prognostic factors for testicular sperm retrieval (15). Lopes et al developed a retrospective study, using OTEM, in which 118 patients with NOA were assessed.…”

Section: Open Testicular Mapping (Otem)mentioning

confidence: 84%

“…The SR technique described by Vieira et al ( 15 ), called Open Testicular Mapping (OTEM), was inspired by Turek's technique ( 26 ) in combination with c-TESE. This minimally invasive, low-cost, and easily reproducible approach has the advantage of not requiring the use of a surgical microscope, requiring less operative time.…”

Section: Techniques For the Treatment Of Non-obstructive Azoospermiamentioning

confidence: 99%

“…In patients with NOA, sperm retrieval can be performed due to the existence of isolated islands of active spermatogenesis within the testicles. Different SR techniques have been described in the literature for this purpose, such as: Testicular Fine Needle Aspiration (TfNA), Conventional Testicular Sperm Extraction (c-TESE), Testicular Sperm Aspiration (TESA), Microdissection TESE (micro-TESE), and Open Testicular Mapping (OTEM) ( 9 , 15 ). Until recently, c-TESE represented the first-line treatment for sperm retrieval in NOA patients for ICSI ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

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Is testicular microdissection the only way to retrieve sperm for non-obstructive azoospermic men?

Vieira

Andrade²,

Santana–Santos

2022

Front. Reprod. Health

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Men presenting with non-obstructive azoospermia are the most challenging clinical scenario for an infertile couple. Intracytoplasmic Sperm Injection (ICSI) with testicular sperm retrieval gave a chance for biological fatherhood once sperm can be found, but unfortunately sperm recovery rate (SSR) is something near 50%, leading to a discussion about what surgical retrieval technique is the best. Historically sperm have been retrieved using conventional Testicular Sperm Extraction (c-TESE), Testicular Sperm Aspiration (TESA), a combination of Testicular Fine Needle Aspiration (TfNA)/c-TESE, Testicular Microdissection (TM) and Open Testicular Mapping (OTEM). c-TESE published in 1995 by Devroey and cols. consists of testis delivery, a large unique albuginea incision and extraction of a portion from the majority of testicular tubules. TESA published in 1996 by Lewin and cols. is done percutaneously using a 21–23 gauge needle and a syringe to aspire testicular tubules. TfNA was published in 1965 by Obrant and Persson as an aspiration biopsy and cytological exam to verify sperm production. In 1999 Turek and cols. published the use of TfNA combined with c-TESE for sperm retrieval. In 1999, Peter Schlegel published a technique using a microsurgical approach to identify more probable sperm production areas inside the testicle that could be excised with better precision and less tissue. OTEM is a multiple biopsy approach, published in 2020 by Vieira and cols., based on TfNA principles but done at the same time without albuginea opening or surgical microscope need. Since Testicular Microdissection publication, the method became the gold standard for sperm retrieval, allowing superior SSR with minimal tissue removal, but the amount of testicular dissection to find more probable spermatogenesis areas, difficulties in comparative design studies, diversity TM results among doctors and other methods that can achieve very similar results we question TM superiority. The objective is review existing literature and discuss advantages and disadvantages of all the methods for sperm retrieval in non-obstructive azoospermia.

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Section: Open Testicular Mapping (Otem)mentioning

confidence: 84%

Section: Techniques For the Treatment Of Non-obstructive Azoospermiamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is testicular microdissection the only way to retrieve sperm for non-obstructive azoospermic men?

Vieira

Andrade²,

Santana–Santos

2022

Front. Reprod. Health

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“…OTEM, introduced by Vieira et al., 10 has had a significant impact on our practices. This technique involves making a hole in the albuginea of the exposed testis using a 19‐G needle without a microscope.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, other methods, such as Fine Needle Aspiration Mapping (FNAP) and Open Testicular Mapping (OTEM), each have their own advantages and disadvantages. 9 , 10 …”

Section: Introductionmentioning

confidence: 99%

Micromapping testicular sperm extraction: A new technique for microscopic testicular sperm extraction in nonobstructive azoospermia

Tai,

Miyamoto,

Fukuoka

et al. 2024

Reprod Medicine & Biology

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PurposeIn microscopic testicular sperm extraction (mTESE) for nonobstructive azoospermia (NOA), sperm can be recovered relatively easily in some cases, and mTESE may be retrospectively considered excessive. However, mTESE is routinely performed in the majority of NOA patients because of the difficulty in predicting tissue status. A minimally invasive and comprehensive sperm retrieval method that allows on‐the‐spot tissue assessment is needed. We have developed and evaluated a novel sperm retrieval technique for NOA called micromapping testicular sperm extraction (MMTSE).MethodsMMTSE involves dividing the testis into four sections and making multiple small needle holes in the tunica albuginea to extract seminiferous tubules and retrieve sperm. The sperm‐positive group by MMTSE (Group I) underwent additional tissue collection (ATC) via a small incision, whereas the sperm‐negative group by MMTSE (Group 0) underwent mTESE.ResultsIn total, 40 NOA participants underwent MMTSE. Group I included 15 patients and Group 0 included 25 patients. In Group 1, sperm were recovered from all patients by ATC. In Group 0, sperm were recovered in 4 of 25 cases using mTESE.ConclusionsMMTSE shows promise as a simple method that comprehensively searches testicular tissue and retrieves sperm using an appropriate method while minimizing patient burden.

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Non-Microsurgical Testis Sperm Extraction

Turek

2024

Reference Module in Biomedical Sciences

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Open testicular mapping: A less invasive multiple biopsy approach for testicular sperm extraction

Cited by 4 publications

References 25 publications

Is testicular microdissection the only way to retrieve sperm for non-obstructive azoospermic men?

Is testicular microdissection the only way to retrieve sperm for non-obstructive azoospermic men?

Micromapping testicular sperm extraction: A new technique for microscopic testicular sperm extraction in nonobstructive azoospermia

Non-Microsurgical Testis Sperm Extraction

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