Toksoz Serdar, Kizilkan Yalçin
Hatay State Hospital, Departments of Urology.
Ankara Numune Training and Research Hospital, Departments of Urology.
Urol J. 2019 May 5;16(2):212-215. doi: 10.22037/uj.v16i2.4756.
Purpose: To investigate the relationship between the histopathological findings of testis tissue samples and sperm retrieval success of micro-TESE in non-obstructive azoospermia (NOA) patients.
Histopathological examination results of the testis tissue samples of 795 NOA patients who underwent micro-TESE operation in our clinic between 2003 and 2014 were included. Histopathological findings were grouped as hypospermatogenesis, incomplete spermatocytic arrest, complete spermatocytic arrest, Sertoli cell only syndrome (SCOS), and fibrosis/atrophy. Chi-square analysis was used to compare the histopathological findings with the sperm retrieval rates of micro-TESE.
Sperm was found in 341 (42,9%) patients following micro-TESE compared to 454(57,1%) patients where sperm were not detected (P < 0.001). Sperm retrieval rates of micro TESE were significantly higher in hyposper-matogenesis and incomplete maturation arrest groups (93.2% (P < 0.001) and 72.5% (P < 0.001), respectively). Complete maturation arrest, SCOS and fibrosis/atrophy were determined at significantly higher rates in patients (220.2%) with no sperm found compared to patients with sperm (P < 0.001).
The findings of this study are consistent with those of previous studies in the literature. Testicular histopathological findings can provide additional data when informing NOA patients about the expected success of further micro-TESE operations.
目的:研究非梗阻性无精子症(NOA)患者睾丸组织样本的组织病理学结果与显微睾丸精子提取术(micro-TESE)取精成功之间的关系。
纳入2003年至2014年在我院接受micro-TESE手术的795例NOA患者的睾丸组织样本的组织病理学检查结果。组织病理学结果分为生精功能低下、不完全精母细胞停滞、完全精母细胞停滞、唯支持细胞综合征(SCOS)以及纤维化/萎缩。采用卡方分析比较组织病理学结果与micro-TESE的取精率。
micro-TESE术后,341例(42.9%)患者发现精子,454例(57.1%)患者未检测到精子(P<0.001)。生精功能低下和不完全成熟停滞组的micro-TESE取精率显著更高(分别为93.2%(P<0.001)和72.5%(P<0.001))。与发现精子的患者相比,未发现精子的患者中完全成熟停滞、SCOS和纤维化/萎缩的发生率显著更高(220.2%)(P<0.001)。
本研究结果与文献中先前的研究结果一致。在告知NOA患者进一步micro-TESE手术的预期成功率时,睾丸组织病理学结果可提供额外的数据。