Giordano Dr. Alessandro, di Giovanni Dr. Angelo, D'alterio Dr. Carlo, Marino Dr. Claudio, Cirigliano Dr. Lorenzo, Napolitano Dr. Luigi, Cariati Dr. Federica, La Rocca Dr. Roberto, Palmieri Prof. Alessandro, Capece Dr. Marco

(218) ONCO-MICROTESE IN PATIENTS SUFFERING FROM CONCOMITANT TESTICULAR CANCER AND AZOOSPERMIA: A SINGLE-CENTER EXPERIENCE

  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
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Abstract Objectives Testicular cancer (TC) accounts for 1% of all tumors and 6-24% of these patients are azoospermic at diagnosis. Moreover in most of these patients, adjuvant chemotherapy results in a decreased spermatogenesis function. The aim of the present study is to report the outcomes of onco-microTESE in our center case series. Methods From January 2019 to September 2022 we enrolled eleven patients aged from twenty-four to thirty-nine affected by testicular cancer and azoospermia. The diagnosis of TC was made by physical examination, scrotal ultrasound and tumor markers (αFP, βHCG, LDH). Two semen analysis and evaluation of testosterone, FSH, LH, estradiol, prolactin were performed before treatment. After surgery, tumor volume (TuV) and testicular volume (TeV) were measured and the ratio between them was evaluated (TuV/TeV). All patients underwent onco-microTESE with the help of an operator microscope and with the aid of a biologist in the surgery room. Statistical analyses were performed to correlate FSH, TuV and TeV. Results Six out of eleven patients had high FSH level while the LH was normal in all patients. In five out of eleven patients testicular volume was <12ml. Spermatozoa were successfully retrieved and frozen from 4/11 testes (36.36%). In all these cases TuV/TeV were <0,1 and in three out of four patients FSH was normal Conclusions In conclusion onco-microTESE should be considered the gold standard for patients with concomitant azoospermia and TC. Despite the low number of patients enrolled due to the rarity of such a condition, we observed a positive correlation between normal FSH and TuV/TeV<0,1 with surgical sperm retrieval (SSR). Further studies are required to evaluate the effective use of these parameters in preoperative evaluation of azoospermic patients with testicular tumors. Conflicts of Interest The Authors declair no conflict of interest.

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