预测非梗阻性无精子症男性睾丸取精成功率的提名图:一项多中心研究。

IF 2.1 3区 医学 Q2 UROLOGY & NEPHROLOGY Urology Pub Date : 2025-02-01 DOI:10.1016/j.urology.2024.10.038
Erman Ceyhan , Mehmet Vehbi Kayra , Eylem Gul Ates , Yalcın Kizilkan , Mesut Altan , Omer Yildirim , Mehmet Hamza Gultekin , Nebil Akdogan , Eray Hasirci , Tufan Cicek , Iyimser Ure , Cem Sah , Aykut Baser , Umit Gul , Hamdi Ozkara , Kadir Emre Akkus , Tahsin Turunc , Andrology Working Group of the Society of Urological Surgery in Turkey
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引用次数: 0

摘要

目的利用术前参数,开发一种高效且易于使用的提名图,以预测非梗阻性无精子症(NOA)男性睾丸取精术(TESE)的成功率:本研究纳入了3093名因无精子症而接受睾丸取精术(TESE)的男性数据。研究记录了人口统计学数据、睾丸体积、是否存在精索静脉曲张、不育时间长短、既往手术史、泌尿生殖系统感染史、吸烟状况、染色体异常、是否存在Y染色体微缺失、不育家族史、睾丸活检、手术数据、取精率、睾丸取精最终病理结果、促卵泡激素、促黄体生成素、睾酮水平。主要研究结果是制定一个有效的提名图,以预测无精子症男性的 TESE 成功率。次要结果是确定与 TESE 成功率相关的重要术前参数:取精率为 50.2%(1553/3093)。结果显示,睾丸体积、精索静脉曲张切除术史、染色体异常、Y染色体微缺失显著影响取精率(p10mL),促卵泡激素水平较低(≤12.92mIU/mL),黄体生成素水平较低,睾酮水平较高(p结论:在无精子症男性中,睾丸体积大、年龄大、促卵泡生成素水平低、黄体生成素水平低和睾酮水平高有利于 TESE 取精成功。在此,我们提出了一个提名图,该图可预测 NOA 男性 TESE 的结果,并可获得足够的成功率。
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A Nomogram Predicting Testicular Sperm Extraction Success in Men With Non-obstructive Azoospermia: A Multi-center Study

OBJECTIVE

To develop an efficient and easy-to-use nomogram that can predict testicular sperm extraction (TESE) success in men with non-obstructive azoospermia (NOA) by using pre-operative parameters.

MATERIALS AND METHODS

Data of 3093 men who underwent TESE for NOA were included in this study. Demographic data, testis volumes, presence of varicocele, length of infertility, history of previous surgeries, history of genitourinary infections, smoking status, chromosome abnormalities, presence of Y-chromosome microdeletion, family history of infertility, testis biopsy, surgical data, sperm retrieval rate, final pathology obtained at TESE, follicle-stimulating hormone, luteinizing hormone, and testosterone levels were recorded. The primary outcome was to develop an efficient nomogram that can predict the TESE success in men with NOA. The secondary outcomes were identifying the significant pre-operative parameters that are associated with success in TESE.

RESULTS

Sperm retrieval rate was 50.2%(1553/3093). Testis volume, history of varicocelectomy, chromosome abnormalities, and presence of Y-chromosome microdeletion were shown to affect sperm retrieval rate significantly (P <.05). Sperm retrieval success was higher in men with older age, higher testis volume (>10 mL), lower follicle-stimulating hormone level (≤12.92 mIU/mL), lower luteinizing hormone level, and higher testosterone level (P <.05). Only testis volume and patient’s age were associated with successful sperm retrieval in multivariate logistic regression analysis.

CONCLUSION

In men with NOA, high testis volume, old age, low follicle-stimulating hormone level, low luteinizing hormone level, and high testosterone level are advantageous for successful sperm retrieval in TESE. Herein, we present a nomogram that can predict the outcome of TESE in men with NOA with adequate success.
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来源期刊
Urology
Urology 医学-泌尿学与肾脏学
CiteScore
3.30
自引率
9.50%
发文量
716
审稿时长
59 days
期刊介绍: Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.
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