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Micro-TESE or microsurgical testicular sperm extraction is a surgical procedure used to retrieve sperm from the maleโ€™s testes, being used for men with non-obstructive azoospermia

โžก๏ธ๐—ง๐—ต๐—ฒ ๐—ฝ๐—ฎ๐˜๐—ถ๐—ฒ๐—ป๐˜ ๐˜€๐—ต๐—ผ๐˜‚๐—น๐—ฑ ๐—ฏ๐—ฒ ๐—ฎ๐—ฏ๐—น๐—ฒ ๐˜๐—ผ ๐—น๐—ฒ๐—ฎ๐˜ƒ๐—ฒ ๐—ต๐—ผ๐˜€๐—ฝ๐—ถ๐˜๐—ฎ๐—น ๐˜€๐—ต๐—ผ๐—ฟ๐˜๐—น๐˜† ๐—ฎ๐—ณ๐˜๐—ฒ๐—ฟ ๐˜๐—ต๐—ฒ ๐—บ๐—ถ๐—ฐ๐—ฟ๐—ผ-๐—ง๐—˜๐—ฆ๐—ฒ ๐—ผ๐—ฝ๐—ฒ๐—ฟ๐—ฎ๐˜๐—ถ๐—ผ๐—ป. You should be driven home by some...
15/08/2021

โžก๏ธ๐—ง๐—ต๐—ฒ ๐—ฝ๐—ฎ๐˜๐—ถ๐—ฒ๐—ป๐˜ ๐˜€๐—ต๐—ผ๐˜‚๐—น๐—ฑ ๐—ฏ๐—ฒ ๐—ฎ๐—ฏ๐—น๐—ฒ ๐˜๐—ผ ๐—น๐—ฒ๐—ฎ๐˜ƒ๐—ฒ ๐—ต๐—ผ๐˜€๐—ฝ๐—ถ๐˜๐—ฎ๐—น ๐˜€๐—ต๐—ผ๐—ฟ๐˜๐—น๐˜† ๐—ฎ๐—ณ๐˜๐—ฒ๐—ฟ ๐˜๐—ต๐—ฒ ๐—บ๐—ถ๐—ฐ๐—ฟ๐—ผ-๐—ง๐—˜๐—ฆ๐—ฒ ๐—ผ๐—ฝ๐—ฒ๐—ฟ๐—ฎ๐˜๐—ถ๐—ผ๐—ป. You should be driven home by someone, especially because judgement is impaired after anesthetics, which can also cause some sore throat, jaw discomfort or muscle aches for 1-2 days.
โžก๏ธIn the same day, it is advised to ๐—ฏ๐—ฒ๐—ด๐—ถ๐—ป ๐—ฑ๐—ฟ๐—ถ๐—ป๐—ธ๐—ถ๐—ป๐—ด ๐—ฐ๐—น๐—ฒ๐—ฎ๐—ฟ ๐—น๐—ถ๐—พ๐˜‚๐—ถ๐—ฑ๐˜€ ๐—ฎ๐—ป๐—ฑ ๐—ฎ๐˜ƒ๐—ผ๐—ถ๐—ฑ ๐—ฎ๐—ป๐˜† ๐—ต๐—ฒ๐—ฎ๐˜ƒ๐˜† ๐—บ๐—ฒ๐—ฎ๐—น๐˜€.
โžก๏ธFor the pain control, ๐˜๐—ต๐—ฒ ๐—ฑ๐—ผ๐—ฐ๐˜๐—ผ๐—ฟ ๐—ฝ๐—ฟ๐—ฒ๐˜€๐—ฐ๐—ฟ๐—ถ๐—ฏ๐—ฒ๐˜€ ๐—ฎ๐—ป๐—ฎ๐—น๐—ด๐—ฒ๐˜€๐—ถ๐—ฐ๐˜€; the pain usually doesnโ€™t last more than 5-7 days.
โžก๏ธ๐—ง๐—ต๐—ฒ ๐—ฝ๐—ต๐˜†๐˜€๐—ถ๐—ฐ๐—ฎ๐—น ๐—ฎ๐—ฐ๐˜๐—ถ๐˜ƒ๐—ถ๐˜๐˜† ๐˜€๐—ต๐—ผ๐˜‚๐—น๐—ฑ ๐—ฏ๐—ฒ ๐—น๐—ถ๐—บ๐—ถ๐˜๐—ฒ๐—ฑ ๐—ถ๐—ป ๐˜๐—ต๐—ฒ ๐—ณ๐—ถ๐—ฟ๐˜€๐˜ 5 ๐—ฑ๐—ฎ๐˜†๐˜€ ๐—ฎ๐—ณ๐˜๐—ฒ๐—ฟ ๐˜€๐˜‚๐—ฟ๐—ด๐—ฒ๐—ฟ๐˜† ๐˜๐—ผ ๐—น๐—ถ๐—ด๐—ต๐˜ ๐—ฎ๐—ฐ๐˜๐—ถ๐˜ƒ๐—ถ๐˜๐˜†. If your job involves desk work/light activity you can resume work in 4-5 days, but you might experience a slight discomfort. For 1-2 weeks after surgery you are forbidden vigorous exercise โ€“ running, heavy lifting, straining, cycling, horseback riding etc.
โžก๏ธThe scrotal swelling is to be expected and it might last a few weeks to return to normal; you should call your doctor if you experience severe swelling and the sc***um becomes very inflamated. ๐——๐˜‚๐—ฟ๐—ถ๐—ป๐—ด ๐˜๐—ต๐—ฒ ๐—ณ๐—ถ๐—ฟ๐˜€๐˜ 48 ๐—ต๐—ผ๐˜‚๐—ฟ๐˜€, ๐˜๐—ต๐—ฒ ๐—ฑ๐—ผ๐—ฐ๐˜๐—ผ๐—ฟ ๐˜„๐—ถ๐—น๐—น ๐—ฟ๐—ฒ๐—ฐ๐—ผ๐—บ๐—บ๐—ฒ๐—ป๐—ฑ ๐—ฎ๐—ฝ๐—ฝ๐—น๐˜†๐—ถ๐—ป๐—ด ๐—ถ๐—ฐ๐—ฒ ๐—ฝ๐—ฎ๐—ฐ๐—ธ๐˜€ ๐˜๐—ผ ๐˜๐—ต๐—ฒ ๐˜€๐—ฐ๐—ฟ๐—ผ๐˜๐˜‚๐—บ ๐—ณ๐—ผ๐—ฟ 15 ๐—บ๐—ถ๐—ป๐˜‚๐˜๐—ฒ๐˜€ ๐—ฒ๐˜ƒ๐—ฒ๐—ฟ๐˜† ๐—ต๐—ผ๐˜‚๐—ฟ; it is important to wrap the ice in a cloth or towel, not place it directly on the skin. Also, you should wear tight underwear to support your sc***um and reduce swelling for the week after surgery.

โ“WHY WOULD SURGICAL S***M RECOVERY BE PERFORMEDโ“The most common reason is because ๐˜€๐—ฝ๐—ฒ๐—ฟ๐—บ ๐—ฎ๐—ฟ๐—ฒ ๐—ป๐—ผ๐˜ ๐—ฝ๐—ฟ๐—ฒ๐˜€๐—ฒ๐—ป๐˜ ๐—ถ๐—ป ๐˜๐—ต๐—ฒ ๐—ฒ๐—ท๐—ฎ๐—ฐ๐˜‚๐—น๐—ฎ๐˜๐—ฒ...
18/07/2021

โ“WHY WOULD SURGICAL S***M RECOVERY BE PERFORMEDโ“

The most common reason is because ๐˜€๐—ฝ๐—ฒ๐—ฟ๐—บ ๐—ฎ๐—ฟ๐—ฒ ๐—ป๐—ผ๐˜ ๐—ฝ๐—ฟ๐—ฒ๐˜€๐—ฒ๐—ป๐˜ ๐—ถ๐—ป ๐˜๐—ต๐—ฒ ๐—ฒ๐—ท๐—ฎ๐—ฐ๐˜‚๐—น๐—ฎ๐˜๐—ฒ. This can be because the vas deferens (the tube which carries s***m from the te**is) can be blocked due to a vasectomy or if the man is a carrier of the genes for cystic fibrosis. Sometimes the s***m are present in the te**is in very low quantities and are not seen in the ej*****te.

โ“WHO NEEDS MICRO-TESEโ“

๐— ๐—ถ๐—ฐ๐—ฟ๐—ผ-๐—ง๐—˜๐—ฆ๐—˜ ๐—ถ๐˜€ ๐—ฟ๐—ฒ๐—ฐ๐—ผ๐—บ๐—บ๐—ฒ๐—ป๐—ฑ๐—ฒ๐—ฑ ๐—ณ๐—ผ๐—ฟ ๐—ฝ๐—ฒ๐—ผ๐—ฝ๐—น๐—ฒ ๐˜„๐—ต๐—ผ ๐—ต๐—ฎ๐˜ƒ๐—ฒ ๐—ฎ๐—ฏ๐—ป๐—ผ๐—ฟ๐—บ๐—ฎ๐—น ๐˜€๐—ฝ๐—ฒ๐—ฟ๐—บ ๐—ฝ๐—ฟ๐—ผ๐—ฑ๐˜‚๐—ฐ๐˜๐—ถ๐—ผ๐—ป (non-obstructive azoos***mia). There are many causes of this including previous testicular surgery, previous medical treatment, a genetic problem, and other male factor infertility issues. Your surgeon will have organised tests to investigate this before surgery.

๐Ÿ‘‰Micro-TESE is a safe procedure in experienced hands and provides infertile men with NOA an opportunity to father childr...
26/06/2021

๐Ÿ‘‰Micro-TESE is a safe procedure in experienced hands and provides infertile men with NOA an opportunity to father children. However, according to a study published in 2018, ๐˜‚๐—ป๐˜€๐—ฒ๐—น๐—ฒ๐—ฐ๐˜๐—ฒ๐—ฑ ๐—ฐ๐—ฎ๐—ป๐—ฑ๐—ถ๐—ฑ๐—ฎ๐˜๐—ฒ๐˜€ ๐˜„๐—ถ๐˜๐—ต ๐—ก๐—ข๐—” ๐˜€๐—ต๐—ผ๐˜‚๐—น๐—ฑ ๐—ฏ๐—ฒ ๐—ฐ๐—ผ๐˜‚๐—ป๐˜€๐—ฒ๐—น๐—น๐—ฒ๐—ฑ ๐—ฎ๐˜ ๐˜๐—ต๐—ฒ ๐—ผ๐˜‚๐˜๐˜€๐—ฒ๐˜ ๐˜๐—ต๐—ฎ๐˜ ๐—ผ๐—ป๐—น๐˜† 17.9% ๐˜„๐—ถ๐—น๐—น ๐—ฒ๐˜ƒ๐—ฒ๐—ป๐˜๐˜‚๐—ฎ๐—น๐—น๐˜† ๐—ฏ๐—ฒ๐—ฐ๐—ผ๐—บ๐—ฒ ๐—ฏ๐—ถ๐—ผ๐—น๐—ผ๐—ด๐—ถ๐—ฐ๐—ฎ๐—น ๐—ณ๐—ฎ๐˜๐—ต๐—ฒ๐—ฟ๐˜€.

โžก๏ธThe sc***um is one of the fastest healing parts of the body, so ๐—บ๐—ผ๐˜€๐˜ ๐—บ๐—ฒ๐—ป ๐—ฟ๐—ฒ๐—ฐ๐—ผ๐˜ƒ๐—ฒ๐—ฟ ๐—พ๐˜‚๐—ถ๐—ฐ๐—ธ๐—น๐˜† ๐—ฎ๐—ป๐—ฑ ๐—ต๐—ฎ๐˜ƒ๐—ฒ ๐˜ƒ๐—ฒ๐—ฟ๐˜† ๐—น๐—ถ๐˜๐˜๐—น๐—ฒ ๐—ฝ๐—ฎ๐—ถ๐—ป after surgery. But your surgeon urologist will prescribe pain medication just in case.

โ˜‘๏ธThe multi-layered closure technique used for the procedure helps to ensure that ๐—บ๐—ฒ๐—ป ๐—ฑ๐—ผ๐—ป'๐˜ ๐—ต๐—ฎ๐˜ƒ๐—ฒ ๐—ถ๐—ป๐—ณ๐—ฒ๐—ฐ๐˜๐—ถ๐—ผ๐—ป๐˜€ ๐—ผ๐—ฟ ๐—ฏ๐—น๐—ฒ๐—ฒ๐—ฑ๐—ถ๐—ป๐—ด ๐—ฎ๐—ณ๐˜๐—ฒ๐—ฟ ๐˜๐—ต๐—ฒ ๐˜€๐˜‚๐—ฟ๐—ด๐—ฒ๐—ฟ๐˜†.

โ“WHAT MAKES MICROTESE SUCCESSFULโ“๐Ÿ‘‰For microTESE to be successful, you need to have ๐—ฎ ๐˜€๐—ธ๐—ถ๐—น๐—น๐—ณ๐˜‚๐—น ๐˜€๐˜‚๐—ฟ๐—ด๐—ฒ๐—ผ๐—ป ๐—ฎ๐—ป๐—ฑ ๐—ฎ๐—ป ๐—ฒ๐˜…๐—ฐ๐—ฒ๐—น๐—น๐—ฒ๐—ป๐˜ ๐—ฎ...
05/06/2021

โ“WHAT MAKES MICROTESE SUCCESSFULโ“

๐Ÿ‘‰For microTESE to be successful, you need to have ๐—ฎ ๐˜€๐—ธ๐—ถ๐—น๐—น๐—ณ๐˜‚๐—น ๐˜€๐˜‚๐—ฟ๐—ด๐—ฒ๐—ผ๐—ป ๐—ฎ๐—ป๐—ฑ ๐—ฎ๐—ป ๐—ฒ๐˜…๐—ฐ๐—ฒ๐—น๐—น๐—ฒ๐—ป๐˜ ๐—ฎ๐—ป๐—ฑ๐—ฟ๐—ผ๐—น๐—ผ๐—ด๐˜† ๐˜๐—ฒ๐—ฐ๐—ต๐—ป๐—ผ๐—น๐—ผ๐—ด๐—ถ๐˜€๐˜ searching for s***m. During your microTESE procedure, an andrology lab technician will be in the operating room to analyze your seminiferous tubules for s***m.

โžก๏ธIf the technician finds s***m during your microTESE, your s***m will be extracted and frozen so they can be used in future reproductive treatments, like ๐—ถ๐—ป-๐˜ƒ๐—ถ๐˜๐—ฟ๐—ผ ๐—ณ๐—ฒ๐—ฟ๐˜๐—ถ๐—น๐—ถ๐˜‡๐—ฎ๐˜๐—ถ๐—ผ๐—ป (๐—œ๐—ฉ๐—™) ๐˜„๐—ถ๐˜๐—ต ๐—ถ๐—ป๐˜๐—ฟ๐—ฎ๐—ฐ๐˜†๐˜๐—ผ๐—ฝ๐—น๐—ฎ๐˜€๐—บ๐—ถ๐—ฐ ๐˜€๐—ฝ๐—ฒ๐—ฟ๐—บ ๐—ถ๐—ป๐—ท๐—ฒ๐—ฐ๐˜๐—ถ๐—ผ๐—ป (๐—œ๐—–๐—ฆ๐—œ).

โ€ผ๏ธCurrent data shows that ๐˜๐—ต๐—ฎ๐˜ ๐—ณ๐—ฟ๐—ผ๐˜‡๐—ฒ๐—ป ๐˜€๐—ฝ๐—ฒ๐—ฟ๐—บ ๐—บ๐—ฎ๐˜† ๐—ฝ๐—ฒ๐—ฟ๐—ณ๐—ผ๐—ฟ๐—บ ๐—ฒ๐˜ƒ๐—ฒ๐—ป ๐—ฏ๐—ฒ๐˜๐˜๐—ฒ๐—ฟ ๐˜๐—ต๐—ฎ๐—ป ๐—ณ๐—ฟ๐—ฒ๐˜€๐—ต ๐˜€๐—ฝ๐—ฒ๐—ฟ๐—บ during IVF (in-vitro fertilization).

๐Ÿ‘‰Overview of preoperative factors considered for prediction of micro-TESE outcome according to a study published in 2013...
22/05/2021

๐Ÿ‘‰Overview of preoperative factors considered for prediction of micro-TESE outcome according to a study published in 2013:

๐Ÿ”น๐—ฆ๐—ฒ๐—ฟ๐˜‚๐—บ ๐—™๐—ฆ๐—› - FSH, although a good predictor of global testicular function, does not serve by itself as a predictor of successful micro-TESE, but models have shown some predictive value when used in conjunction with other variables
๐Ÿ”น๐—ฆ๐—ฒ๐—ฟ๐˜‚๐—บ ๐—œ๐—ป๐—ต๐—ถ๐—ฏ๐—ถ๐—ป ๐—• - Inhibin B, like FSH, does not serve as a good predictor of micro-TESE by itself, but models have shown predictive value when used in conjunction with other variables
๐Ÿ”น๐—›๐—ถ๐˜€๐˜๐—ผ๐—ฝ๐—ฎ๐˜๐—ต๐—ผ๐—น๐—ผ๐—ด๐˜† - Histopathology is likely the greatest single predictor of successful micro-TESE, but the requirement of a separate surgical procedure for diagnosis makes its role very limited
๐Ÿ”น๐—ง๐—ฒ๐˜€๐˜๐—ถ๐—ฐ๐˜‚๐—น๐—ฎ๐—ฟ ๐˜ƒ๐—ผ๐—น๐˜‚๐—บ๐—ฒ - The data on testicular volume and its predictive value for micro-TESE is limited, and suggests that it is not a good predictive variable for micro-TESE
๐Ÿ”น๐—š๐—ฒ๐—ป๐—ฒ๐˜๐—ถ๐—ฐ๐˜€ - Genetics, particularly Y chromosome microdeletions, are very helpful in predicting success of micro-TESE; men with AZFc microdeletions have very good chance of successful micro-TESE, whereas those men with AZFa or AZFb have a low probability of success
Klinefelterโ€™s Syndrome (KS) - Men with KS have successful micro-TESE rates similar to or better than all men with NOA, and KS itself is a good prognostic factor for s***m retrieval
๐Ÿ”น๐—”๐—ด๐—ฒ - While advanced paternal age may play a role in decreased pregnancy rates, the limited studies thus far show that it does not play a predictive role for micro-TESE
๐Ÿ”น๐—–๐—ฟ๐˜†๐—ฝ๐˜๐—ผ๐—ฟ๐—ฐ๐—ต๐—ถ๐—ฑ๐—ถ๐˜€๐—บ - Men with a history of cryptorchidism have successful micro-TESE rates to men without cryptorchidism, suggesting that it does not play a predictive role in the success of micro-TESE
๐Ÿ”น๐—ฉ๐—ฎ๐—ฟ๐—ถ๐—ฐ๐—ผ๐—ฐ๐—ฒ๐—น๐—ฒ - The need for varicocelectomy in men with a varicocele and NOA prior to micro-TESE is debated, but men with a clinical varicocele who undergo varicocelectomy prior to micro-TESE have higher s***m retrieval rates compared to men with all other causes of NOA, suggesting that varicocele repair is a positive prognostic factor for men undergoing micro-TESE

โ„น๏ธSeveral studies in the literature report ๐˜€๐˜‚๐—ฐ๐—ฐ๐—ฒ๐˜€๐˜€๐—ณ๐˜‚๐—น ๐˜€๐—ฝ๐—ฒ๐—ฟ๐—บ ๐—ฟ๐—ฒ๐—ฐ๐—ผ๐˜ƒ๐—ฒ๐—ฟ๐˜† ๐˜„๐—ถ๐˜๐—ต ๐˜€๐—ฎ๐—น๐˜ƒ๐—ฎ๐—ด๐—ฒ ๐—บ๐—ถ๐—ฐ๐—ฟ๐—ผ-๐—ง๐—˜๐—ฆ๐—˜ ๐—ฎ๐—ณ๐˜๐—ฒ๐—ฟ ๐—ณ๐—ฎ๐—ถ๐—น๐—ฒ๐—ฑ ๐—ฐ๐—ผ๐—ป๐˜ƒ๐—ฒ๐—ป๐˜๐—ถ๐—ผ๐—ป๐—ฎ๐—น ๐—ง...
10/05/2021

โ„น๏ธSeveral studies in the literature report ๐˜€๐˜‚๐—ฐ๐—ฐ๐—ฒ๐˜€๐˜€๐—ณ๐˜‚๐—น ๐˜€๐—ฝ๐—ฒ๐—ฟ๐—บ ๐—ฟ๐—ฒ๐—ฐ๐—ผ๐˜ƒ๐—ฒ๐—ฟ๐˜† ๐˜„๐—ถ๐˜๐—ต ๐˜€๐—ฎ๐—น๐˜ƒ๐—ฎ๐—ด๐—ฒ ๐—บ๐—ถ๐—ฐ๐—ฟ๐—ผ-๐—ง๐—˜๐—ฆ๐—˜ ๐—ฎ๐—ณ๐˜๐—ฒ๐—ฟ ๐—ณ๐—ฎ๐—ถ๐—น๐—ฒ๐—ฑ ๐—ฐ๐—ผ๐—ป๐˜ƒ๐—ฒ๐—ป๐˜๐—ถ๐—ผ๐—ป๐—ฎ๐—น ๐—ง๐—˜๐—ฆ๐—˜.

In this direction study published in July 2020, a retrospective cohort, involved 125 men with a failed previous micro-TESE at health institutions who underwent repeated micro-TESE between November 2014 and July 2018. Clinical parameters of the patients were compared for the success of s***m recovery between the patients who had successful s***m recovery and who did not have.

โžก๏ธ๐—ฆ๐—ฝ๐—ฒ๐—ฟ๐—บ ๐˜„๐—ฎ๐˜€ ๐˜€๐˜‚๐—ฐ๐—ฐ๐—ฒ๐˜€๐˜€๐—ณ๐˜‚๐—น๐—น๐˜† ๐—ฟ๐—ฒ๐—ฐ๐—ผ๐˜ƒ๐—ฒ๐—ฟ๐—ฒ๐—ฑ ๐—ถ๐—ป 23 ๐—ผ๐—ณ 125 (18,4%) ๐—บ๐—ฒ๐—ป ๐˜„๐—ถ๐˜๐—ต ๐—ฟ๐—ฒ๐—ฝ๐—ฒ๐—ฎ๐˜๐—ฒ๐—ฑ ๐—บ๐—ถ๐—ฐ๐—ฟ๐—ผ-๐—ง๐—˜๐—ฆ๐—˜.

Repeated micro-TESE achieved s***m retrieval in 18.4% of men with NOA (nonobstructive azoos***mia) who failed the first micro-TESE. This cohort is the largest repeat micro-TESE series in patients with NOA who have a failed initial micro-TESE attempt.

โ€ผ๏ธWhen consulting the patients who had a failed Micro TESE, the results from the current study may enable for them ๐˜ƒ๐—ฎ๐—น๐˜‚๐—ฎ๐—ฏ๐—น๐—ฒ ๐—ถ๐—ป๐—ณ๐—ผ๐—ฟ๐—บ๐—ฎ๐˜๐—ถ๐—ผ๐—ป ๐—ฏ๐—ฒ๐—ณ๐—ผ๐—ฟ๐—ฒ ๐˜๐—ต๐—ฒ ๐—ฑ๐—ฒ๐—ฐ๐—ถ๐˜€๐—ถ๐—ผ๐—ป ๐˜๐—ผ ๐—ฟ๐—ฒ๐—ฝ๐—ฒ๐—ฎ๐˜ ๐—บ๐—ถ๐—ฐ๐—ฟ๐—ผ ๐—ง๐—˜๐—ฆ๐—˜.

Dr.Vakalidis wishes you health and peaceful holidays!
01/05/2021

Dr.Vakalidis wishes you health and peaceful holidays!

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