Yıl 2019, Cilt 14 , Sayı 3, Sayfalar 176 - 181 2019-10-01

Unilateral Microscopic Testicular Sperm Extraction in Non-Obstructive Azoospermia
Non-Obstrüktif Azospermide Tek Taraflı Mikroskopik Testiküler Sperm Ekstraksiyonu

Erdem Koç [1] , Fevzi Bedir [2] , İbrahim Karabulut [3] , İsa Özbey [4] , Özkan Polat [5]


Purpose: We aimed to present the results of unilateral microscopic testicular sperm extraction (mTESE) in non-obstructive azoospermia (NOA) cases in our clinic and to elucidate the factors affecting mTESE success. 


Materials and MethodsOur study was prospectively designed and 102 NOA patients were included. Testis volumes, serum follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and testosterone (T) levels were measured and genetic evaluations were carried out. We performed mTESE and divided patients into two groups according to sperm extraction results as mTESE is successful (sperm could be found) or failed (sperm could not be found). The two groups were compared in demographic, clinical and histopathological data.


Results: Sperm extraction by mTESE was successful in 64 (62.7%) patients. There was no significant difference between two groups in terms of age, infertility times, serum T and PRL levels (p=0.896, p=0.357, p=0.504, p=0.179, respectively). Serum FSH and LH levels were significantly lower, and the mean testis volume was significantly higher in the group that micro-TESE was successful (p=0.004, p=0.001, p=0.029, respectively). Histopathological evaluation revealed a significant difference between hypospermatogenesis, sertoli cell only syndrome (SCOS) and maturation arrest (MA) groups in terms of mTESE success (88.5%, 37.5%, 30%, respectively; p<0.001).


Conclusion: Our unilateral mTESE success rate was similar to those performed bilaterally in literature. Besides the multiple predictive factors of mTESE success rate, unilaterally performed mTESE is less invasive procedure preserving the integrity of the contralateral testis and may be advantageous in terms of improving salvage mTESE results. 

Amaç: Çalışmamızda, kliniğimizdeki non-obstrüktif azoospermi (NOA) olgularında tek taraflı mikroskobik testiküler sperm ekstraksiyonu (mTESE) sonuçlarımızı sunmayı ve başarıyı etkileyen faktörleri ortaya koymayı amaçladık.

Gereç ve Yöntemler: Çalışmamıza toplam 102 NOA hastası dahil edildi. Hastaların testis hacimleri, serum folikül uyarıcı hormon (FSH), lüteinizan hormon (LH), prolaktin (PRL) ve testosteron (T) düzeyleri ölçüldü, genetik değerlendirmeleri yapıldı. Ardından mTESE uygulanarak hastalar, sperm ekstraksiyonunun başarılı (sperm bulunan) veya başarısız (sperm bulunmayan) olmasına göre iki gruba ayrıldı. Gruplar demografik, klinik ve histopatolojik veriler açısından karşılaştırıldı.

Bulgular: mTESE ile sperm ekstraksiyonu başarı oranımız %62.7 idi (n=64). İki grup arasında yaş, infertilite süresi, serum T ve PRL düzeyleri açısından anlamlı fark yoktu (sırasıyla p=0.896, p=0.357, p=0.504, p=0.179). mTESE'nin başarılı olduğu grupta ortalama testis hacmi anlamlı olarak daha yüksek olup, serum FSH ve LH düzeyleri anlamlı olarak düşüktü (sırasıyla p=0.029, p=0.004, p=0.001). Histopatolojik değerlendirmede mTESE başarısı açısından hipospermatogenez, sertoli cell only sendromu (SCOS) ve matürasyon arrest (MA) grupları arasında anlamlı fark bulundu (sırasıyla % 88.5, %37.5, % 30; p<0.001).

Sonuç: Tek taraflı mTESE başarı oranımız, daha önce bildirilen bilateral serilerle benzer olarak bulundu. mTESE başarısını etkileyen birden çok prediktif faktör bulunmakla birlikte, tek taraflı mTESE uygulamasının daha az invaziv olması ve kontralateral testis bütünlüğünün korunması nedeniyle kurtarma mTESE açısından avantaj sağlayabilir. 

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Birincil Dil en
Konular Üroloji ve Nefroloji
Bölüm Özgün Araştırma
Yazarlar

Orcid: 0000-0003-3439-2105
Yazar: Erdem Koç (Sorumlu Yazar)
Kurum: Ankara Atatürk Training and Research Hospital, Department of Urology
Ülke: Turkey


Orcid: 0000-0003-0506-0777
Yazar: Fevzi Bedir
Kurum: University of Health Sciences, Erzurum State Training and Research Hospital, Department of Urology
Ülke: Turkey


Orcid: 0000-0002-2035-598X
Yazar: İbrahim Karabulut
Kurum: University of Health Sciences, Erzurum State Training and Research Hospital, Department of Urology
Ülke: Turkey


Orcid: 0000-0002-7889-3174
Yazar: İsa Özbey
Kurum: Erzurum Atatürk University, Faculty of Medicine, Department of Urology
Ülke: Turkey


Orcid: 0000-0001-9961-662X
Yazar: Özkan Polat
Kurum: Erzurum Atatürk University, Faculty of Medicine, Department of Urology
Ülke: Turkey


Tarihler

Yayımlanma Tarihi : 1 Ekim 2019

Bibtex @araştırma makalesi { yud513792, journal = {Yeni Üroloji Dergisi}, issn = {1305-2489}, eissn = {2687-1955}, address = {dergi@avrasyauroonkoloji.org}, publisher = {Ali İhsan TAŞÇI}, year = {2019}, volume = {14}, pages = {176 - 181}, doi = {10.33719/yud.513792}, title = {Unilateral Microscopic Testicular Sperm Extraction in Non-Obstructive Azoospermia}, key = {cite}, author = {Koç, Erdem and Bedir, Fevzi and Karabulut, İbrahim and Özbey, İsa and Polat, Özkan} }
APA Koç, E , Bedir, F , Karabulut, İ , Özbey, İ , Polat, Ö . (2019). Unilateral Microscopic Testicular Sperm Extraction in Non-Obstructive Azoospermia. Yeni Üroloji Dergisi , 14 (3) , 176-181 . DOI: 10.33719/yud.513792
MLA Koç, E , Bedir, F , Karabulut, İ , Özbey, İ , Polat, Ö . "Unilateral Microscopic Testicular Sperm Extraction in Non-Obstructive Azoospermia". Yeni Üroloji Dergisi 14 (2019 ): 176-181 <https://dergipark.org.tr/tr/pub/yud/issue/47273/513792>
Chicago Koç, E , Bedir, F , Karabulut, İ , Özbey, İ , Polat, Ö . "Unilateral Microscopic Testicular Sperm Extraction in Non-Obstructive Azoospermia". Yeni Üroloji Dergisi 14 (2019 ): 176-181
RIS TY - JOUR T1 - Unilateral Microscopic Testicular Sperm Extraction in Non-Obstructive Azoospermia AU - Erdem Koç , Fevzi Bedir , İbrahim Karabulut , İsa Özbey , Özkan Polat Y1 - 2019 PY - 2019 N1 - doi: 10.33719/yud.513792 DO - 10.33719/yud.513792 T2 - Yeni Üroloji Dergisi JF - Journal JO - JOR SP - 176 EP - 181 VL - 14 IS - 3 SN - 1305-2489-2687-1955 M3 - doi: 10.33719/yud.513792 UR - https://doi.org/10.33719/yud.513792 Y2 - 2019 ER -
EndNote %0 Yeni Üroloji Dergisi Unilateral Microscopic Testicular Sperm Extraction in Non-Obstructive Azoospermia %A Erdem Koç , Fevzi Bedir , İbrahim Karabulut , İsa Özbey , Özkan Polat %T Unilateral Microscopic Testicular Sperm Extraction in Non-Obstructive Azoospermia %D 2019 %J Yeni Üroloji Dergisi %P 1305-2489-2687-1955 %V 14 %N 3 %R doi: 10.33719/yud.513792 %U 10.33719/yud.513792
ISNAD Koç, Erdem , Bedir, Fevzi , Karabulut, İbrahim , Özbey, İsa , Polat, Özkan . "Unilateral Microscopic Testicular Sperm Extraction in Non-Obstructive Azoospermia". Yeni Üroloji Dergisi 14 / 3 (Ekim 2019): 176-181 . https://doi.org/10.33719/yud.513792
AMA Koç E , Bedir F , Karabulut İ , Özbey İ , Polat Ö . Unilateral Microscopic Testicular Sperm Extraction in Non-Obstructive Azoospermia. Yeni Üroloji Dergisi. 2019; 14(3): 176-181.
Vancouver Koç E , Bedir F , Karabulut İ , Özbey İ , Polat Ö . Unilateral Microscopic Testicular Sperm Extraction in Non-Obstructive Azoospermia. Yeni Üroloji Dergisi. 2019; 14(3): 181-176.