Althakafi Sultan A, Mustafa Osama M, Seyam Raouf M, Al-Hathal Naif, Kattan Said
Urology Department, King Saud Medical City, Riyadh, Saudi Arabia.
Urology Department, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
Transl Androl Urol. 2017 Apr;6(2):282-287. doi: 10.21037/tau.2017.02.04.
Microdissection testicular sperm extraction (microTESE) has become the standard of care for sperm retrieval in non-obstructive azoospermia (NOA) patients. Understanding the significant determinants of microTESE outcomes may result in improvements in sperm retrieval rates and provide better-informed clinical decisions.
This is a clinical retrospective study conducted through chart review of 421 NOA patients who underwent microTESE between August 2009 and July 2015 in a tertiary-care referral hospital. Clinical, biochemical and histopathological characteristics were collected. Normal serum testosterone level was defined as testosterone >9.9 nmol/L. Multiple logistic regression was used to identify determinants of microTESE in the studied population. A P<0.05 was considered significant.
Sperms were successfully retrieved in 39.4% of cases. The average testosterone level was 11.51±7.40 and 11.67±6.42 in patients with successful and unsuccessful microTESE, respectively (P=0.820). No significant association was found between serum testosterone level and sperm motility and amount. Of all variables, histological subtype remained to be the most significant determinant of microTESE outcomes in the examined population, with hypospermatogenesis having over a 3-fold higher odd of successful microTESE than sertoli-cell only.
Serum testosterone level appears to have no significant association with microTESE outcomes in NOA. The underlying histological pattern is a significant determinant of the procedure's success.
显微切割睾丸取精术（microTESE）已成为非梗阻性无精子症（NOA）患者取精的标准治疗方法。了解影响microTESE结果的重要决定因素可能会提高精子获取率，并为临床决策提供更充分的依据。
这是一项临床回顾性研究，通过查阅2009年8月至2015年7月在一家三级转诊医院接受microTESE的421例NOA患者的病历进行。收集临床、生化和组织病理学特征。正常血清睾酮水平定义为睾酮>9.9 nmol/L。采用多因素logistic回归分析确定研究人群中microTESE的决定因素。P<0.05被认为具有统计学意义。
39.4%的病例成功获取精子。microTESE成功和失败患者的平均睾酮水平分别为11.51±7.40和11.67±6.42（P=0.820）。血清睾酮水平与精子活力和数量之间未发现显著相关性。在所有变量中，组织学亚型仍是所研究人群中microTESE结果的最显著决定因素，生精功能低下患者成功进行microTESE的几率比唯支持细胞综合征患者高出3倍以上。
血清睾酮水平似乎与NOA患者的microTESE结果无显著相关性。潜在的组织学模式是该手术成功的重要决定因素。
