Salvage mTESE after previous failed mTESE: results and predictors for success
Author(s):
Mr Amr Moubasher
,
Mr Amr Moubasher
Affiliations:
Miss Odunayo Kalejaiye
,
Miss Odunayo Kalejaiye
Affiliations:
Mr A. Abdel Raheem
,
Mr A. Abdel Raheem
Affiliations:
Mr Giovanni Chiriaco
,
Mr Giovanni Chiriaco
Affiliations:
Mr Marco Capece
,
Mr Marco Capece
Affiliations:
Miss Phillipa Sangstar
,
Miss Phillipa Sangstar
Affiliations:
Mr Nim Christopher
,
Mr Nim Christopher
Affiliations:
Mr Asif Muneer
,
Mr Asif Muneer
Affiliations:
Mr Giulio Garaffa
,
Mr Giulio Garaffa
Affiliations:
Mr David Ralph
Mr David Ralph
Affiliations:
BAUS ePoster online library. Moubasher A. 06/27/17; 177380; P4-14
Mr. Amr Moubasher
Mr. Amr Moubasher
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Abstract
Discussion Forum (0)
Rate & Comment (0)
Objectives
Microdissection testicular sperm extraction (mTESE) is considered the gold standard for the retrieval of sperm in men with non-obstructive azoospermia with success rates approaching 50%. However a significant proportion of couples wish to be considered for repeat attempts at sperm retrieval after a failed initial mTESE. The aim of this study was to determine the success rates of redo mTESE at our centre.
Methods
Twenty-three patients with non-obstructive azoospermia were identified from a prospective database between 2011 and 2016. All had undergone previous unsuccessful mTESE with a diagnostic testis biopsy. Hormonal profile and testicular histopathology data were collected. Twenty-two men were started on hormonal manipulation with Clomid for 6 months prior to a repeat mTESE. 3 men with a grade 3 varicocele had microsurgical varicocelectomy.
Results
Overall the mean age of men identified was 37.8 years. The commonest pathological findings from first testis biopsy were maturation arrest (n=11) and Sertoli cell only syndrome (n=7). Twelve men had normal testosterone when started on Clomid. The success rate of repeat mTESE was 35% (n=8). The 3 men who underwent varicocelectomy and Clomid treatment all had a successful repeat mTESE. Maturation arrest was more common in the failure group (n=9; 60%) compared with the success group (n=2; 25%).
Conclusion
There is limited evidence on the utility of repeat mTESE in men who have previously failed the same procedure. Our data suggests that sperm may still be found after an initial failed mTESE following hormonal manipulation and treatment of clinical varicocele.

Objectives
Microdissection testicular sperm extraction (mTESE) is considered the gold standard for the retrieval of sperm in men with non-obstructive azoospermia with success rates approaching 50%. However a significant proportion of couples wish to be considered for repeat attempts at sperm retrieval after a failed initial mTESE. The aim of this study was to determine the success rates of redo mTESE at our centre.
Methods
Twenty-three patients with non-obstructive azoospermia were identified from a prospective database between 2011 and 2016. All had undergone previous unsuccessful mTESE with a diagnostic testis biopsy. Hormonal profile and testicular histopathology data were collected. Twenty-two men were started on hormonal manipulation with Clomid for 6 months prior to a repeat mTESE. 3 men with a grade 3 varicocele had microsurgical varicocelectomy.
Results
Overall the mean age of men identified was 37.8 years. The commonest pathological findings from first testis biopsy were maturation arrest (n=11) and Sertoli cell only syndrome (n=7). Twelve men had normal testosterone when started on Clomid. The success rate of repeat mTESE was 35% (n=8). The 3 men who underwent varicocelectomy and Clomid treatment all had a successful repeat mTESE. Maturation arrest was more common in the failure group (n=9; 60%) compared with the success group (n=2; 25%).
Conclusion
There is limited evidence on the utility of repeat mTESE in men who have previously failed the same procedure. Our data suggests that sperm may still be found after an initial failed mTESE following hormonal manipulation and treatment of clinical varicocele.

Code of conduct/disclaimer available in General Terms & Conditions

By clicking “Accept Terms & all Cookies” or by continuing to browse, you agree to the storing of third-party cookies on your device to enhance your user experience and agree to the user terms and conditions of this learning management system (LMS).

Cookie Settings
Accept Terms & all Cookies