Microdissection TESE (mTESE) outcomes following adult orchidopexy for intra-abdominal and inguinal testicles
Author(s):
Miss Michelle Christodoulidou
,
Miss Michelle Christodoulidou
Affiliations:
Dr Mahmoud Ziada
,
Dr Mahmoud Ziada
Affiliations:
Dr Fabio Castiglione
,
Dr Fabio Castiglione
Affiliations:
Mr Arie Parnham
,
Mr Arie Parnham
Affiliations:
Ms Elizabeth Williamson
,
Ms Elizabeth Williamson
Affiliations:
Dr Alex Freeman
,
Dr Alex Freeman
Affiliations:
Professor John Kelly
,
Professor John Kelly
Affiliations:
Mr Khaled Dawas
,
Mr Khaled Dawas
Affiliations:
Mr Asif Muneer
Mr Asif Muneer
Affiliations:
BAUS ePoster online library. Christodoulidou M. 06/27/17; 177379; P4-13 Disclosure(s): I declare no conflict of interest
Ms. Michelle Christodoulidou
Ms. Michelle Christodoulidou
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Abstract
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Introduction

Adults with undescended testicles (UDT) may only be detected when investigated for infertility. Relocating the testicles into the scrotum followed by a delayed surgical sperm retrieval (mTESE) may retrieve sperm for future ICSI treatment.

Patients and methods

We retrospectively reviewed patients undergoing orchidopexy for either intra-abdominal or inguinal testicles. All patients were azoospermic and had undergone MRI localisation of the testicles.

Results

Ten patients (age 18 to 36) underwent orchidopexy for inguinal or intra-abdominal testes with a mean follow-up of 34 months (range 13 to 58). 90% of patients had bilateral UDT with azoospermia. Bilateral intra-abdominal testes (20%) underwent a robot-assisted orchidopexy, however a delayed mTESE failed to retrieve sperm in these patients. Three cases with a unilateral intra-abdominal testicle and a contralateral inguinal testicle underwent a robot-assisted orchidectomy and simultaneous back table mTESE which again failed to retrieve sperm. A total of 12 inguinal orchidopexies in 8 patients were performed with successful mTESE in 37.5%. There were no reported cases of ITGCN and mean Johnsen scores ranged from 1 to 3.3. Pre-operative testosterone levels were within the normal range (9.1 to 24.2, mean 9.4 nmol/L) and only one patient required post-operative testosterone replacement therapy.

Conclusions

In adult patients, successful mTESE is still possible (37.5%) following inguinal orchidopexy. Adult orchidopexy also preserves endocrine function. Intra-abdominal testicles lack exocrine function and therefore younger men should be counselled for orchidectomy.
Introduction

Adults with undescended testicles (UDT) may only be detected when investigated for infertility. Relocating the testicles into the scrotum followed by a delayed surgical sperm retrieval (mTESE) may retrieve sperm for future ICSI treatment.

Patients and methods

We retrospectively reviewed patients undergoing orchidopexy for either intra-abdominal or inguinal testicles. All patients were azoospermic and had undergone MRI localisation of the testicles.

Results

Ten patients (age 18 to 36) underwent orchidopexy for inguinal or intra-abdominal testes with a mean follow-up of 34 months (range 13 to 58). 90% of patients had bilateral UDT with azoospermia. Bilateral intra-abdominal testes (20%) underwent a robot-assisted orchidopexy, however a delayed mTESE failed to retrieve sperm in these patients. Three cases with a unilateral intra-abdominal testicle and a contralateral inguinal testicle underwent a robot-assisted orchidectomy and simultaneous back table mTESE which again failed to retrieve sperm. A total of 12 inguinal orchidopexies in 8 patients were performed with successful mTESE in 37.5%. There were no reported cases of ITGCN and mean Johnsen scores ranged from 1 to 3.3. Pre-operative testosterone levels were within the normal range (9.1 to 24.2, mean 9.4 nmol/L) and only one patient required post-operative testosterone replacement therapy.

Conclusions

In adult patients, successful mTESE is still possible (37.5%) following inguinal orchidopexy. Adult orchidopexy also preserves endocrine function. Intra-abdominal testicles lack exocrine function and therefore younger men should be counselled for orchidectomy.
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