A Novel Stepwise Approach of Microtese in Nonobstructive Azoospermia

Franco, Giorgio; Zavaglia, Daniela; Cavaliere, Arturo; Iacobelli, Marcello; Leonardo, Costantino; Cillis, Antonio De; Petrucci, F.; Greco, Ermanno

doi:10.1016/s0022-5347(09)62039-5

Cited by 3 publications

(1 citation statement)

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“…A seguito di queste considerazioni, con uno studio prospettico su 65 pazienti, abbiamo di recente proposto un approccio “graduale” di MicroTESE, al fine di ridurre l'invasività e di ottimizzare i risultati, in particolare in quei pazienti nei quali non si hanno dati a sufficienza per stabilire la gravità del danno spermatogenetico (87, 88). In anestesia locale (infiltrazione del cordone spermatico e della cute) o generale, mediante una piccola incisione scrotale, viene eseguita una singola biopsia testicolare (5 mm) destinata in parte all'analisi istologica e in parte inviata al laboratorio per il recupero degli spermatozoi.…”

Section: Recupero DI Spermatozoi Per Pmaunclassified

Surgery of male infertility: An update

et al. 2014

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Surgery for male infertility includes three main areas: varicocele surgery, recanalization of seminal tract, sperm retrieval.Varicocele treatment in infertily is still controversial. Recent scientific evidence appears to demonstrate that in selected cases varicocele treatment is beneficial in improving semen parameters and pregnancy rate. The key for the success of treatment seems to be a correct indication. It is our opinion that varicocele should be treated in presence of abnormal semen parameters, when clinically significant, and in adolescents with atrophy of the affected testis. So far, no specific technique, either surgical, microsurgical or sclerotherapic, can be considered the gold standard. Good results in our hands have been obtained with the microsurgical lymphatic sparing high ligation of internal spermatic vein.Innovations in surgery for seminal tract obstructions include the new tubular invagination techniques for epididimovasostomy, which showed excellent results with a simplified and time-saving microsurgical approach. In distal obstructions, a new transperineal ultrasound-guided approach has been proposed for the diagnostic work-up and treatment. Advantages of this technique and of the TURED must be balanced with those of immediate sperm retrieval for ART.In sperm retrieval, microTESE represents the most important surgical evolution in non-obstructive azoospermia. We have recently proposed a new stepwise approach starting with a minimal equatorial incision for conventional testicular biopsy which is extended to perform microTESE only when no sperm is retrieved. In this way microTESE is offered only to patients who really need it. Another field of innovation is sperm retrieval for ICSI in patients with Klinefelter Syndrome.

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Section: Recupero DI Spermatozoi Per Pmaunclassified