Mohammad Reza Nowroozi, Hamed Ahmadi, Mohsen Ayati, Hasan Jamshidian, Ali Sirous
{"title":"睾丸细针穿刺与睾丸开放活检:选定患者的精子回收率比较。","authors":"Mohammad Reza Nowroozi, Hamed Ahmadi, Mohsen Ayati, Hasan Jamshidian, Ali Sirous","doi":"10.4103/0970-1591.94954","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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]).</p><p><strong>Aims: </strong>To develop a predictive model for SRR by TESA and to identify factors associated with comparable SRR between TESA and TESE.</p><p><strong>Settings and design: </strong>Single-center controlled cross-sectional study on 450 infertile men with nonobstructive azoospermia.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Statistical analysis used: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":520644,"journal":{"name":"Indian journal of urology : IJU : journal of the Urological Society of India","volume":" ","pages":"37-42"},"PeriodicalIF":0.0000,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/15/c6/IJU-28-37.PMC3339784.pdf","citationCount":"18","resultStr":"{\"title\":\"Testicular fine-needle aspiration versus testicular open biopsy: Comparable sperm retrieval rate in selected patients.\",\"authors\":\"Mohammad Reza Nowroozi, Hamed Ahmadi, Mohsen Ayati, Hasan Jamshidian, Ali Sirous\",\"doi\":\"10.4103/0970-1591.94954\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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]).</p><p><strong>Aims: </strong>To develop a predictive model for SRR by TESA and to identify factors associated with comparable SRR between TESA and TESE.</p><p><strong>Settings and design: </strong>Single-center controlled cross-sectional study on 450 infertile men with nonobstructive azoospermia.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Statistical analysis used: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":520644,\"journal\":{\"name\":\"Indian journal of urology : IJU : journal of the Urological Society of India\",\"volume\":\" \",\"pages\":\"37-42\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2012-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/15/c6/IJU-28-37.PMC3339784.pdf\",\"citationCount\":\"18\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian journal of urology : IJU : journal of the Urological Society of India\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.4103/0970-1591.94954\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian journal of urology : IJU : journal of the Urological Society of India","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/0970-1591.94954","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Testicular fine-needle aspiration versus testicular open biopsy: Comparable sperm retrieval rate in selected patients.
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.
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