Janosek-Albright Kirsten J C, Schlegel Peter N, Dabaja Ali A
Department of Urology, Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA.
Department of Urology, Weill Cornell Medical College, New York, NY, USA.
Asian J Urol. 2015 Apr;2(2):79-84. doi: 10.1016/j.ajur.2015.04.018. Epub 2015 Apr 16.
The last 20 years have produced developments in the treatment for patients with non-obstructive azoospermia (NOA) who were once considered to be infertile. The combination of intracytoplasmic sperm injection together with various testicular sperm retrieval techniques, including conventional testicular sperm extraction (TESE), microdissection TESE (micro-TESE) and fine needle aspiration (FNA), have revolutionized treatment for these men. In men with NOA, isolated regions of spermatogenesis within the testis are common. The goal for all types of sperm retrieval procedures is locating the focal region(s) of spermatogenesis, and harvesting the sperm for assisted reproduction. This review article explores the surgical management of men with NOA and describes all techniques that can be used for testicular sperm retrieval. A PubMed search was conducted using the key words: "sperm extraction", "NOA", "testicular FNA", "testicular mapping", "TESE", and "testicular biopsy". All articles were reviewed. Articles were included if they provided data on sperm retrieval rates. The methods for performing sperm retrieval rates and outcomes of the various techniques are outlined. Micro-TESE has a higher sperm retrieval rates with fewer postoperative complications and negative effects on testicular function compared with conventional TESE.
在过去20年里，针对曾经被认为不育的非梗阻性无精子症（NOA）患者的治疗取得了进展。卵胞浆内单精子注射与各种睾丸精子获取技术相结合，包括传统睾丸精子提取术（TESE）、显微外科睾丸精子提取术（显微TESE）和细针抽吸术（FNA），彻底改变了对这些男性的治疗方式。在患有NOA的男性中，睾丸内孤立的生精区域很常见。所有类型的精子获取程序的目标都是定位生精的焦点区域，并采集精子用于辅助生殖。这篇综述文章探讨了NOA男性的手术管理，并描述了可用于睾丸精子获取的所有技术。使用关键词“精子提取”、“NOA”、“睾丸FNA”、“睾丸图谱”、“TESE”和“睾丸活检”在PubMed上进行了搜索。对所有文章进行了审查。如果文章提供了精子获取率的数据，则将其纳入。概述了各种技术的精子获取率和结果的执行方法。与传统TESE相比，显微TESE具有更高的精子获取率，术后并发症更少，对睾丸功能的负面影响也更小。
