title: No relationship between biopsy sites near the main testicular vessels or rete testis and successful sperm retrieval using conventional or microdissection biopsies in 220 non-obstructive azoospermic men.
abstract: In 220 consecutive patients with non-obstructive azoospermia, sperm retrieval was attempted by a combination of conventional and microdissection testicular sperm extraction (TESE). For sperm retrieval, 2-3 conventional biopsies were performed followed by a microdissection TESE in cases of negative conventional biopsies. During the surgery, the vasculature of the testis was assessed using the operative microscope, and the location of positive biopsies was registered in relation to the blood supply. The overall sperm retrieval rate was 58.2%. From the initial conventional biopsies, sperm could be retrieved in 46.8% of the patients. With microdissection TESE, sperm could be retrieved from an additional 11.4% of the patients. The further use of microdissection TESE improved the sperm retrieval rate significantly (P=0.017). No significant accumulation of positive biopsies was found towards the rete testis or the main testicular vessels.
authors.affiliation: Andrologie Centrum München, München D-81241, Germany.
authors.forename: J Ullrich
authors.initials: JU
authors.lastname: Schwarzer
authors.forename: Heiko
authors.initials: H
authors.lastname: Steinfatt
authors.forename: Manfred
authors.initials: M
authors.lastname: Schleyer
authors.forename: Frank M
authors.initials: FM
authors.lastname: Köhn
authors.forename: Klaus
authors.initials: K
authors.lastname: Fiedler
authors.forename: Irene
authors.initials: I
authors.lastname: von Hertwig
authors.forename: Gottfried
authors.initials: G
authors.lastname: Krüsmann
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Würfel
mesh_terms: D053713:Azoospermia / Q000473:pathology*; D001706:Biopsy; D001808:Blood Vessels / Q000473:pathology*; D006801:Humans; D008297:Male; D013737:Testis / Q000098:blood supply* / Q000473:pathology