A Comparative Study of Equatorial and Longitudinal Incision Techniques in Microdissection Sperm Extraction for Nonobstructive Azoospermic Patients

OBJECTIVE To compare sperm retrieval rates (SRR), postoperative pain, testicular volume, and postoperative testosterone levels between equatorial incisional microdissection testicular sperm extraction (micro-TESE) and longitidunal incisional micro-TESE in nonobstructive azoosMETHODS Fifty NOA patients undergoing equatorial incisional micro-TESE were retrospectively assigned to group 1, while 50 patients undergoing longitidunal incisional micro-TESE were prospectively assigned to group 2. Demographic data, operative time, postoperative pain assessed via the visual analog scale, complications, SRR, and hormonal evaluations (FSH, LH, total testosterone) were recorded. Both groups compared in terms of preoperative demographic and clinical characteristics. SRR, testicular volume and postoperative testosterone, FSH, LH compared between study groups. RESULTS SRR were significantly higher in group 2 (62%) compared to group 1 (42%) (P = .045). No significant differences in operative time, visual analog scale pain scores, or postoperative complications were observed between groups. Hormonal evaluations showed a statistically significant decrease in testosterone levels for both groups at 3 months, but no significant differences between groups. Testicular volume decreased postoperatively in both groups, with no significant differences between them. CONCLUSION Longitidunal incisional micro-TESE significantly improves SRR without increasing complication rates compared to equatorial incisional micro-TESE. These findings suggest that the longitidunal incisional micro-TESE may be a valuable advancement in the surgical management of NOA patients, warranting further research and clinical validation. UROLOGY 197: 101- 107, 2025. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Journal

UROLOGY

Year

2025

Volume

197

Pages

101-107

ISSN

0090-4295

eISSN

1527-9995

DOI

10.1016/j.urology.2024.12.031

WoS UID

WOS:001444939100001

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