ORLANDO, FL (UroToday) - Testicular sperm extraction (TESE), in combination with intracytoplasmic sperm injection.

One of the "complications" of this procedure is hypogonadism. Microdissection techniques have been reported to decrease this risk.

This is a retrospective record review of 80 azoospermic patients (55 with 46XY males with nonobstructive azoospermia and 25 Klinefelters syndrome. Serum follicle-stimulating hormone (FSH), lutenizing hormone (LH), and testosterone (T) concentrations were evaluated before and at 6 and 12 months after surgery. In 46XY males with NOA, serum levels of FSH at 6 and 12 months and LH at 6 months after operation were significantly increased from baseline concentrations and no significant differences were observed in the levels of LH at 12 months and T at 6 and 12 months compared to baseline concentrations. T declined in KS patients significantly from base line concentrations at all time after surgery. FSH and LH concentrations in patients with KS were not significantly changed.

The authors conclude that Long term hormonal follow up is recommended after MD-TESE, particularly in patients with KS.

Editorial Comment: This study does not assess the benefits of micro-tese versus other sperm acquisition strategies. However, it does point out that hypogonadism is a risk of the procedure and this appears greater in the KS patients. Clearly, this risk needs to assessed in each patient who may undergo sperm acquisition. Base line hormonal evaluation is essential to this risk assessment.

Presented by Yutaka Kondo, MD, et al., at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday Contributing Editor Harris M. Nagler, MD

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