From Clinical Presentations of NOA Males
to Predict the Outcome of Microdissection TESE
Ming-Hsuan Ku1, William J.S. Huang 1,2,3, I-Shen Huang 1,2,3, Alex T.L. Lin 1,2,3, Kuang-Kuo Chen 1,2,3
Department of Urology, Taipei Veterans General Hospital 1,
Department of Urology 2, School of Medicine and Shu-Tien Urological Science Research Center 3,
National Yang-Ming University, Taipei, Taiwan
Purpose: To understand the predictive value of clinical presentation of infertile patients with non-obstructive azoospermia (NOA) on the outcome of microdissection testicular sperm extraction (micro-TESE) in Taiwan.
Materials and Methods: We retrospectively reviewed the database of Taipei Veterans General Hospital from January 2012 to December 2014. Totally 200 patients with NOA who had undergone micro-TESE surgery were enrolled. The etiology, pathologic findings and sperm retrieval rate (SRR) of different etiologies and pathologic findings were reviewed in this study.
Results: In our study, 30.8% of our patients had genetic disorders; 7.7% with bil. prominent varicoceles; 6.4% with hypogonadotropic hypogonadism or Kallmann syndrome; 6.4% with undescended testes (UDT) history; 46.2% belonging to idiopathic etiology.
During this period, 123 patients had undergone testicular biopsies, and the pathology results were as followed :SCOS (65.9%), EMA(9.1%), hypospermatogenesis (22.7%), tubular hyalinization (4.5%). The SRR of micro-TESE from each pathology group were SCOS (27.6%), EMA( 0%), hypospermatogenesis (88.9%), tubular hyalinization (0%).
The SRR of each clinical presentations of patients were as followed: UDT histories (80%), prominent varicoceles (33.3%), hypogonadotropic hypogonadonism or Kallmann syndrome (100%), genetic related disease (20.8%).
This study gives a useful information of prognosis in NOA patients based on the picture of clinical presentation. The prediction may be more informative if further pathological data from testis biopsy are available.