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Surgical Sperm Retrieval Procedures and Varicocele Repair in Office Urology
Surgical Sperm Retrieval Procedures and Varicocele Repair in Office Urology
Surgical Sperm Retrieval Procedures and Varicocele Repair in Office Urology
Endocrine Antisperm
disorders antibody
>20% 8-19%
Changes
• Refraining from excessive alcohol intake.
• Avoidance of activity/clothing which may elevate scrotal temperature.
• May result from prior toxic exposures (i.e. chemotherapy, radiation), genetic
abnormality, cryptorchidism, or varicoceles.
“The rates of fertilization and pregnancy were 56% and 39% in the 66 PESA-ICSI
cycles, respectively, and 47% and 45% in the 40 MESA-ICSI cycles. No significant
differences were found in fertilization rates or pregnancy rates among the various
sperm retrieval methods and obstruction etiologies.”
Overall sperm retrieval rate (SRR) ranged from 16.7-45% in the conventional TESE vs 42.9-63% in the mTESE.
Deruyver Y et al., Andrology 2013
Result of a Meta-Analysis on the Outcome of
mTESE Compared with Conventional TESE
• Retroperitoneal (high) ligation of the testicular artery and vein above the
internal inguinal ring (Palomo technique).
• High ligation of the vein while sparing the artery (Bernardi technique).
• Ligation of the cremasteric and internal spermatic veins within the inguinal
canal (Ivanissevich technique).
• Inguinal microsurgical technique.
• Subinguinal microsurgical technique.
• Laparoscopic high ligation.
• Ante/retrograde sclerotherapy.