Microdissection testicular sperm extraction in men with Sertoli cell-only testicular histology.

OBJECTIVE

To study the outcomes of microdissection testicular sperm extraction (microTESE) among men with pure Sertoli cell-only histology on diagnostic testicular biopsy.

DESIGN

Retrospective cohort study.

SETTING

Tertiary referral center.

PATIENT(S): Six hundred forty patients with pure Sertoli cell-only histology on testicular biopsy who underwent microTESE by a single surgeon.

INTERVENTION(S): MicroTESE.

MAIN OUTCOME MEASURE(S): Sperm retrieval rates.

RESULT(S): Overall, 44.5% of patients with Sertoli cell only had sperm retrieved with microTESE. No difference was noted in sperm retrieval rates based on testis volume (≥15 mL vs. <15 mL, 35.3% vs. 46.1%, respectively). Patients with ≥15 mL testicular volume and FSH 10-15 mU/mL had the worst prognosis, with a sperm retrieval rate of 6.7%.

CONCLUSION(S): Patients with previous testicular biopsy demonstrating Sertoli cell-only histology can be counseled that they have a reasonable likelihood of sperm retrieval with the contemporary delivery of microTESE. Given this finding, the utility of testicular biopsy before microTESE is further questioned.