Fertility and Sterility
Volume 91, Issue 3 , Pages 925-928, March 2009

Use of subinguinal incision for microsurgical testicular biopsy during varicocelectomy in men with nonobstructive azoospermia

  • Marcello Cocuzza, M.D.

      Affiliations

    • Department of Urology, University of São Paulo, São Paulo, Brazil
    • Corresponding Author InformationReprint requests: Marcello Cocuzza, M.D., Department of Urology, University of São Paulo, Rua Adma Jafet, 50 151/152, São Paulo 01308-050, Brazil (FAX: 55-11-3256-9511).
  • ,
  • Rodrigo Pagani, M.D.

      Affiliations

    • Department of Urology, University of São Paulo, São Paulo, Brazil
  • ,
  • Roberto Iglesias Lopes, M.D.

      Affiliations

    • Department of Urology, University of São Paulo, São Paulo, Brazil
  • ,
  • Kelly S. Athayde, M.T., M.S.

      Affiliations

    • Department of Urology, University of São Paulo, São Paulo, Brazil
    • Reproductive Research Center, Glickman Urological Institute and Department of Obstetrics and Gynecology, Cleveland Clinic, Cleveland, Ohio
  • ,
  • Antonio M. Lucon, M.D., Ph.D.

      Affiliations

    • Department of Urology, University of São Paulo, São Paulo, Brazil
  • ,
  • Miguel Srougi, M.D., PhD.

      Affiliations

    • Department of Urology, University of São Paulo, São Paulo, Brazil
  • ,
  • Jorge Hallak, M.D., Ph.D.

      Affiliations

    • Department of Urology, University of São Paulo, São Paulo, Brazil

Received 5 September 2007; received in revised form 13 December 2007; accepted 19 December 2007. published online 21 July 2008.

Objective

To describe a subinguinal technique of microsurgical testicular biopsy performed during subinguinal varicocelectomy in men with nonobstructive azoospermia.

Design

Prospective clinical study.

Setting

Andrology laboratory at tertiary care hospital. Male infertility section, department of urology, at tertiary care hospital.

Patient(s)

Ten azoospermic men with clinical varicocele.

Intervention(s)

Subinguinal microsurgical testicular biopsy and microsurgical varicocele repair.

Main Outcome Measure(s)

Safety, feasibility, and effectiveness of subinguinal testicular biopsy during varicocele repair.

Result(s)

All testes were easily delivered through the subinguinal incision, and testicular biopsies were successfully performed under microscopic view. After a median follow-up of 9 months, none of the patients had any discomfort, pain, or presented with testicular atrophy. No intraoperative or postoperative complications were observed. There was no incidence of wound infection or scrotal hematoma.

Conclusion(s)

The subinguinal approach is a safe and effective option for testicular biopsy during varicocele repair in men with nonobstructive azoospermia. This technique may be an attractive alternative to traditional biopsy because it obviates scrotal violation.

Key Words: Varicocele, testicular biopsy, male infertility, nonobstructive azoospermia, microsurgery

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PII: S0015-0282(07)04338-5

doi:10.1016/j.fertnstert.2007.12.065

Fertility and Sterility
Volume 91, Issue 3 , Pages 925-928, March 2009