Discordant clinical and histological findings predict failure of reconstruction in suspected obstructive azoospermia.
Aims and Objectives: To analyze testicular histopathology in men diagnosed as idiopathic obstructive azoospermia (IOA) based on normal spermatogenesis on fine needle aspiration cytology (FNAC) but with absence of sperms in the epididymis during surgical exploration. Materials and Methods: Men presen...
| Publicado en: | Indian Journal of Urology Vol. 28; no. 1; pp. 43 - 47 |
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| Autores principales: | , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
Wolters Kluwer India Pvt Ltd
Jan-Mar2012
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104560698&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104560698 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09701591 1KUG jtl: Indian Journal of Urology issn: 09701591 maglogo: N pubinfo: dt: Jan-Mar2012 vid: 28 iid: 1 pid: 16919 pub: Wolters Kluwer India Pvt Ltd artinfo: ui: 104560698 74732845 10.4103/0970-1591.94955 NLM22557716 PMC3339785 104560698 ppf: 43 ppct: 4 formats: fmt: @attributes: type: P tig: atl: Discordant clinical and histological findings predict failure of reconstruction in suspected obstructive azoospermia. aug: au: Sahay, Shailesh C. Iyer, Venkateswaran K. Kumar, Rajeev affil: Department of Urology, All India Institute of Medical Sciences, New Delhi, India sug: subj: Men's Health Infertility Treatment Failure Risk Assessment Human India Prospective Studies Biopsy, Needle Semen Analysis Follicle-Stimulating Hormone Analysis Anastomosis, Surgical Decision Making, Clinical ab: Aims and Objectives: To analyze testicular histopathology in men diagnosed as idiopathic obstructive azoospermia (IOA) based on normal spermatogenesis on fine needle aspiration cytology (FNAC) but with absence of sperms in the epididymis during surgical exploration. Materials and Methods: Men presenting with infertility due to IOA during the study period from July 2008 to July 2010 were prospectively evaluated. Clinical examination, semen analysis, serum follicle stimulating hormone (FSH), and testicular FNAC were done. Men with normal volume azoospermia with normal spermatogenesis on FNAC and palpable vas were offered scrotal exploration for microsurgical vasoepididymal anastomosis (VEA). Patients in whom reconstruction was not feasible intraoperatively were analyzed for the causes of failure. The FNAC, FSH and biopsy of these patients were compared. Results: 77 men fulfilled the inclusion criteria. In 38 men, sperm was present in the epididymal fluid and VEA was performed. In 39 men, reconstruction was not feasible. Thirty-four of these 39 men had normal FSH and testicular volume. In 5 of these 39 men, serum FSH was high (mean 17.48 mIU/ml) and testes were small in size (mean volume 14.5 ml). Testicular biopsy in two of these five men showed patchy areas of atrophy, while the other three men had hyalinized seminiferous tubules with thickened basement membrane, maturation arrest and normal spermatogenesis, respectively. Conclusion: FNAC was discordant with histopathological examination (HPE) in four out of five patients of negative surgical exploration with raised FSH. Therefore, among men with idiopathic azoospermia, only those with both normal FSH and normal FNAC should be diagnosed as obstructive azoospermia and explored. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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