Outcomes and predictive factors of successful salvage microdissection testicular sperm extraction (mTESE) after failed classic TESE: results from a multicenter cross-sectional study

Microdissection testicular sperm extraction (mTESE) has been proposed as a salvage treatment option for men with a previously failed classic TESE (cTESE), but data are scarce. We aimed to assess the outcome of and potential predictors of successful salvage mTESE in a cohort of men previously submitt...

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Published in:International journal of impotence research 2022-12, Vol.34 (8), p.795-799
Main Authors: Boeri, Luca, Bebi, Carolina, Dente, Donato, Greco, Ermanno, Turetti, Matteo, Capece, Marco, Cocci, Andrea, Cito, Gianmartin, Preto, Mirko, Pescatori, Edoardo, Ciampaglia, Walter, Scroppo, Fabrizio Ildefonso, Falcone, Marco, Ceruti, Carlo, Gadda, Franco, Franco, Giorgio, Dehò, Federico, Palmieri, Alessandro, Rolle, Luigi, Gontero, Paolo, Montorsi, Francesco, Montanari, Emanuele, Salonia, Andrea
Format: Article
Language:English
Subjects:
692/499
692/700/565/545
Azoospermia - pathology
Azoospermia - surgery
Biopsy
Cross-Sectional Studies
Follicle Stimulating Hormone
Humans
Male
Medicine
Medicine & Public Health
Microdissection - methods
Oligospermia
Regression analysis
Reproductive Medicine
Retrospective Studies
rology
Semen
Sperm
Spermatozoa
Testes
Urological surgery
Urology
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Summary:Microdissection testicular sperm extraction (mTESE) has been proposed as a salvage treatment option for men with a previously failed classic TESE (cTESE), but data are scarce. We aimed to assess the outcome of and potential predictors of successful salvage mTESE in a cohort of men previously submitted to unfruitful cTESE. Data from 61 men who underwent mTESE after a failed cTESE between 01/2014 and 10/2020, at 6 tertiary-referral centres in Italy were analysed. All men were investigated with semen analyses, testicular ultrasound, hormonal and genetic blood testing. Pathological diagnosis from TESE was collected in every man. Descriptive statistics and logistic regression models were used to investigate potential predictors of positive sperm retrieval (SR+) after salvage mTESE. Baseline serum Follicle-Stimulating hormone (FSH) and total testosterone levels were 17.2 (8.6–30.1) mUI/mL and 4.7 (3.5-6.4) ng/mL, respectively. Sertoli-cell-only syndrome (SCOS), maturation arrest (MA) and hypospermatogenesis were found in 24 (39.3%), 21 (34.4%) and 16 (26.2%) men after cTESE, respectively. At mTESE, SR+ was found in 30 (49.2%) men. Patients with a diagnosis of hypospermatogenesis had a higher rate of SR+ (12/16 (75%)) compared to MA (12/21 (57.1%)) and SCOS (6/24 (25%)) patients at mTESE ( p  
ISSN:0955-9930
1476-5489
DOI:10.1038/s41443-021-00487-8