Year : 2012 | Volume
: 28 | Issue : 1 | Page : 37--42
Testicular fine-needle aspiration versus testicular open biopsy: Comparable sperm retrieval rate in selected patients
Mohammad Reza Nowroozi, Hamed Ahmadi, Mohsen Ayati, Hasan Jamshidian, Ali Sirous
Department of Urology, Imam-Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Background: Sperm recovery by testicular fine-needle aspiration (TESA) has resulted in variable sperm retrieval rate (SRR) and is generally considered inferior to open biopsy (testicular sperm extraction [TESE]).
Aims: To develop a predictive model for SRR by TESA and to identify factors associated with comparable SRR between TESA and TESE.
Settings and Design: Single-center controlled cross-sectional study on 450 infertile men with nonobstructive azoospermia.
Materials and Methods: Clinical, paraclinical, and histological information of patients were gathered. All patients underwent both TESA and TESE in a single operation. Predictors of SRR by TESA were identified, and the accuracy of TESA in predicting the outcome of TESE was determined.
Statistical Analysis Used: Categorical and continuous variables were compared using independent t test and -chi-square test. Logistic regression model was applied to develop a predictive model for SRR by TESA. Receiver Operating Characteristics (ROC) curve analysis was used to determine the accuracy of TESA in predicting TESE outcome.
Results: Sperm retrieval rate for TESA and TESE was 41.8 and 50.9%, respectively (P = 0.04). Age, duration of infertility, testis volume, luteinizing hormone, prolactin, and testosterone did not differ between patients with and without mature sperm in TESA samples. Serum follicular-stimulating hormone (FSH) < 15 IU/l (Exp (B) = 4.8, 95% CI: 1.4-18.5; P = 0.001) and histology of hypospermatogenesis (Exp (B) = 6.4, 95% CI: 2.1-27.4; P < 0.001) were predictors of SRR by TESA. In patients with FSH < 15 IU/l (57.4% versus 59.5%; Area under the curve (AUC) = 0.907) and testicular histology of hypospermatogenesis (68.0% versus 70.5%; AUC = 0.890), the SRR by TESA was predictive of SRR by TESE.
Conclusions: Serum FSH and testicular pathology were predictors of SRR by TESA. Patients with FSH < 15 IU/l and/or testicular pathology of hypospermatogenesis had comparable SRR by TESA versus TESE.
Department of Urology, Imam-Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran 1419733141
|How to cite this article:|
Nowroozi MR, Ahmadi H, Ayati M, Jamshidian H, Sirous A. Testicular fine-needle aspiration versus testicular open biopsy: Comparable sperm retrieval rate in selected patients.Indian J Urol 2012;28:37-42
|How to cite this URL:|
Nowroozi MR, Ahmadi H, Ayati M, Jamshidian H, Sirous A. Testicular fine-needle aspiration versus testicular open biopsy: Comparable sperm retrieval rate in selected patients. Indian J Urol [serial online] 2012 [cited 2020 Jul 14 ];28:37-42
Available from: http://www.indianjurol.com/article.asp?issn=0970-1591;year=2012;volume=28;issue=1;spage=37;epage=42;aulast=Nowroozi;type=0