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Testicular fine-needle aspiration as a prognostic indicator in azoospermia associated with grade II varicocele

Taha, Emad A.; Gaber, Hisham D.; Fawzy, Mohamed; Hasan, Hosam A.; Mohamed, Abdelmonem A.; Hassan, Ahmed M.; Abbas, Ahmed M.

doi: 10.1097/01.XHA.0000508139.53000.b9
Original Articles

Purpose The current study aims to evaluate the prognostic indicators of testicular fine-needle aspiration (TFNA) findings on the outcome of varicocele (Vx) surgery.

Patients and methods The study was a multicentric prospective cohort study carried out in Ibnsina, Sohag and Banon, Assiut ICSI centers, Egypt. We included all infertile men with nonobstructive azoospermia diagnosed with grade II bilateral Vx. TFNA was done for all men, and according to the presence or absence of sperms in TFNA smears they were divided into two groups: group I, Vx patients with positive TFNA, and group II, Vx patients with negative TFNA. Next, patients were subjected to inguinal-loupe-assisted Vx ligation. The primary outcome of the study was the rate of improvement in semen parameters within 1 year after surgery.

Results Postoperative semen analyses in both groups revealed that 18/33 (54.5%) patients in group I versus 10/48 (20.8%) in group II had positive sperms in their ejaculates with statistically significant difference (P=0.001). In addition, semen parameters in group I had significantly higher results than group II. There were significant positive correlations between the number of recovered sperms by TFNA preoperatively and the total testicular volume on one hand and postoperative semen parameters on the other hand (P<0.001), whereas significant negative correlations were found between serum follicle-stimulating hormone (FSH) and postoperative semen parameters (P<0.001).

Conclusion Taking prognostic parameters into consideration is important before counseling nonobstructive azoospermia patients with Vx to undergo varicocelectomy. The findings of sperms preoperatively through performing TFNA could be a good prognostic indicator to varicocelectomy.

Departments of aDermatology, Venereology and Andrology

bDiagnostic Radiology

cObstetrics and Gynecology, Faculty of Medicine, Assiut University

dDepartment of General Surgery, Faculty of Medicine, Al-Azhar University, Assiut

eDepartment of Physiology, Faculty of Medicine, Sohag University, Sohag, Egypt

fEbn Sina and Banon ICSI Centers, Sohag, Egypt

Correspondence to Ahmed M. Abbas, MD, Department of Obstetrics and Gynecology, Woman’s Health Hospital, Assiut University, 71511 Assiut, Egypt Tel: +20 88 241 4616; fax: + 20 88 2414631; e-mail:

Received August 9, 2016

Accepted September 25, 2016

© 2016 Human Andrology
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