Micro-TESE

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

➡️𝗧𝗵𝗲 𝗽𝗮𝘁𝗶𝗲𝗻𝘁 𝘀𝗵𝗼𝘂𝗹𝗱 𝗯𝗲 𝗮𝗯𝗹𝗲 𝘁𝗼 𝗹𝗲𝗮𝘃𝗲 𝗵𝗼𝘀𝗽𝗶𝘁𝗮𝗹 𝘀𝗵𝗼𝗿𝘁𝗹𝘆 𝗮𝗳𝘁𝗲𝗿 𝘁𝗵𝗲 𝗺𝗶𝗰𝗿𝗼-𝗧𝗘𝗦𝗲 𝗼𝗽𝗲𝗿𝗮𝘁𝗶𝗼𝗻. You should be driven home by some...
15/08/2021

➡️𝗧𝗵𝗲 𝗽𝗮𝘁𝗶𝗲𝗻𝘁 𝘀𝗵𝗼𝘂𝗹𝗱 𝗯𝗲 𝗮𝗯𝗹𝗲 𝘁𝗼 𝗹𝗲𝗮𝘃𝗲 𝗵𝗼𝘀𝗽𝗶𝘁𝗮𝗹 𝘀𝗵𝗼𝗿𝘁𝗹𝘆 𝗮𝗳𝘁𝗲𝗿 𝘁𝗵𝗲 𝗺𝗶𝗰𝗿𝗼-𝗧𝗘𝗦𝗲 𝗼𝗽𝗲𝗿𝗮𝘁𝗶𝗼𝗻. 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.
➡️In the same day, it is advised to 𝗯𝗲𝗴𝗶𝗻 𝗱𝗿𝗶𝗻𝗸𝗶𝗻𝗴 𝗰𝗹𝗲𝗮𝗿 𝗹𝗶𝗾𝘂𝗶𝗱𝘀 𝗮𝗻𝗱 𝗮𝘃𝗼𝗶𝗱 𝗮𝗻𝘆 𝗵𝗲𝗮𝘃𝘆 𝗺𝗲𝗮𝗹𝘀.
➡️For the pain control, 𝘁𝗵𝗲 𝗱𝗼𝗰𝘁𝗼𝗿 𝗽𝗿𝗲𝘀𝗰𝗿𝗶𝗯𝗲𝘀 𝗮𝗻𝗮𝗹𝗴𝗲𝘀𝗶𝗰𝘀; the pain usually doesn’t last more than 5-7 days.
➡️𝗧𝗵𝗲 𝗽𝗵𝘆𝘀𝗶𝗰𝗮𝗹 𝗮𝗰𝘁𝗶𝘃𝗶𝘁𝘆 𝘀𝗵𝗼𝘂𝗹𝗱 𝗯𝗲 𝗹𝗶𝗺𝗶𝘁𝗲𝗱 𝗶𝗻 𝘁𝗵𝗲 𝗳𝗶𝗿𝘀𝘁 5 𝗱𝗮𝘆𝘀 𝗮𝗳𝘁𝗲𝗿 𝘀𝘂𝗿𝗴𝗲𝗿𝘆 𝘁𝗼 𝗹𝗶𝗴𝗵𝘁 𝗮𝗰𝘁𝗶𝘃𝗶𝘁𝘆. 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 – running, heavy lifting, straining, cycling, horseback riding etc.
➡️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. 𝗗𝘂𝗿𝗶𝗻𝗴 𝘁𝗵𝗲 𝗳𝗶𝗿𝘀𝘁 48 𝗵𝗼𝘂𝗿𝘀, 𝘁𝗵𝗲 𝗱𝗼𝗰𝘁𝗼𝗿 𝘄𝗶𝗹𝗹 𝗿𝗲𝗰𝗼𝗺𝗺𝗲𝗻𝗱 𝗮𝗽𝗽𝗹𝘆𝗶𝗻𝗴 𝗶𝗰𝗲 𝗽𝗮𝗰𝗸𝘀 𝘁𝗼 𝘁𝗵𝗲 𝘀𝗰𝗿𝗼𝘁𝘂𝗺 𝗳𝗼𝗿 15 𝗺𝗶𝗻𝘂𝘁𝗲𝘀 𝗲𝘃𝗲𝗿𝘆 𝗵𝗼𝘂𝗿; 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.

❓WHY WOULD SURGICAL S***M RECOVERY BE PERFORMED❓The most common reason is because 𝘀𝗽𝗲𝗿𝗺 𝗮𝗿𝗲 𝗻𝗼𝘁 𝗽𝗿𝗲𝘀𝗲𝗻𝘁 𝗶𝗻 𝘁𝗵𝗲 𝗲𝗷𝗮𝗰𝘂𝗹𝗮𝘁𝗲...
18/07/2021

❓WHY WOULD SURGICAL S***M RECOVERY BE PERFORMED❓

The most common reason is because 𝘀𝗽𝗲𝗿𝗺 𝗮𝗿𝗲 𝗻𝗼𝘁 𝗽𝗿𝗲𝘀𝗲𝗻𝘁 𝗶𝗻 𝘁𝗵𝗲 𝗲𝗷𝗮𝗰𝘂𝗹𝗮𝘁𝗲. 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.

❓WHO NEEDS MICRO-TESE❓

𝗠𝗶𝗰𝗿𝗼-𝗧𝗘𝗦𝗘 𝗶𝘀 𝗿𝗲𝗰𝗼𝗺𝗺𝗲𝗻𝗱𝗲𝗱 𝗳𝗼𝗿 𝗽𝗲𝗼𝗽𝗹𝗲 𝘄𝗵𝗼 𝗵𝗮𝘃𝗲 𝗮𝗯𝗻𝗼𝗿𝗺𝗮𝗹 𝘀𝗽𝗲𝗿𝗺 𝗽𝗿𝗼𝗱𝘂𝗰𝘁𝗶𝗼𝗻 (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.

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

👉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, 𝘂𝗻𝘀𝗲𝗹𝗲𝗰𝘁𝗲𝗱 𝗰𝗮𝗻𝗱𝗶𝗱𝗮𝘁𝗲𝘀 𝘄𝗶𝘁𝗵 𝗡𝗢𝗔 𝘀𝗵𝗼𝘂𝗹𝗱 𝗯𝗲 𝗰𝗼𝘂𝗻𝘀𝗲𝗹𝗹𝗲𝗱 𝗮𝘁 𝘁𝗵𝗲 𝗼𝘂𝘁𝘀𝗲𝘁 𝘁𝗵𝗮𝘁 𝗼𝗻𝗹𝘆 17.9% 𝘄𝗶𝗹𝗹 𝗲𝘃𝗲𝗻𝘁𝘂𝗮𝗹𝗹𝘆 𝗯𝗲𝗰𝗼𝗺𝗲 𝗯𝗶𝗼𝗹𝗼𝗴𝗶𝗰𝗮𝗹 𝗳𝗮𝘁𝗵𝗲𝗿𝘀.

➡️The sc***um is one of the fastest healing parts of the body, so 𝗺𝗼𝘀𝘁 𝗺𝗲𝗻 𝗿𝗲𝗰𝗼𝘃𝗲𝗿 𝗾𝘂𝗶𝗰𝗸𝗹𝘆 𝗮𝗻𝗱 𝗵𝗮𝘃𝗲 𝘃𝗲𝗿𝘆 𝗹𝗶𝘁𝘁𝗹𝗲 𝗽𝗮𝗶𝗻 after surgery. But your surgeon urologist will prescribe pain medication just in case.

☑️The multi-layered closure technique used for the procedure helps to ensure that 𝗺𝗲𝗻 𝗱𝗼𝗻'𝘁 𝗵𝗮𝘃𝗲 𝗶𝗻𝗳𝗲𝗰𝘁𝗶𝗼𝗻𝘀 𝗼𝗿 𝗯𝗹𝗲𝗲𝗱𝗶𝗻𝗴 𝗮𝗳𝘁𝗲𝗿 𝘁𝗵𝗲 𝘀𝘂𝗿𝗴𝗲𝗿𝘆.

❓WHAT MAKES MICROTESE SUCCESSFUL❓👉For microTESE to be successful, you need to have 𝗮 𝘀𝗸𝗶𝗹𝗹𝗳𝘂𝗹 𝘀𝘂𝗿𝗴𝗲𝗼𝗻 𝗮𝗻𝗱 𝗮𝗻 𝗲𝘅𝗰𝗲𝗹𝗹𝗲𝗻𝘁 𝗮...
05/06/2021

❓WHAT MAKES MICROTESE SUCCESSFUL❓

👉For microTESE to be successful, you need to have 𝗮 𝘀𝗸𝗶𝗹𝗹𝗳𝘂𝗹 𝘀𝘂𝗿𝗴𝗲𝗼𝗻 𝗮𝗻𝗱 𝗮𝗻 𝗲𝘅𝗰𝗲𝗹𝗹𝗲𝗻𝘁 𝗮𝗻𝗱𝗿𝗼𝗹𝗼𝗴𝘆 𝘁𝗲𝗰𝗵𝗻𝗼𝗹𝗼𝗴𝗶𝘀𝘁 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.

➡️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 𝗶𝗻-𝘃𝗶𝘁𝗿𝗼 𝗳𝗲𝗿𝘁𝗶𝗹𝗶𝘇𝗮𝘁𝗶𝗼𝗻 (𝗜𝗩𝗙) 𝘄𝗶𝘁𝗵 𝗶𝗻𝘁𝗿𝗮𝗰𝘆𝘁𝗼𝗽𝗹𝗮𝘀𝗺𝗶𝗰 𝘀𝗽𝗲𝗿𝗺 𝗶𝗻𝗷𝗲𝗰𝘁𝗶𝗼𝗻 (𝗜𝗖𝗦𝗜).

‼️Current data shows that 𝘁𝗵𝗮𝘁 𝗳𝗿𝗼𝘇𝗲𝗻 𝘀𝗽𝗲𝗿𝗺 𝗺𝗮𝘆 𝗽𝗲𝗿𝗳𝗼𝗿𝗺 𝗲𝘃𝗲𝗻 𝗯𝗲𝘁𝘁𝗲𝗿 𝘁𝗵𝗮𝗻 𝗳𝗿𝗲𝘀𝗵 𝘀𝗽𝗲𝗿𝗺 during IVF (in-vitro fertilization).

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

👉Overview of preoperative factors considered for prediction of micro-TESE outcome according to a study published in 2013:

🔹𝗦𝗲𝗿𝘂𝗺 𝗙𝗦𝗛 - 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
🔹𝗦𝗲𝗿𝘂𝗺 𝗜𝗻𝗵𝗶𝗯𝗶𝗻 𝗕 - 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
🔹𝗛𝗶𝘀𝘁𝗼𝗽𝗮𝘁𝗵𝗼𝗹𝗼𝗴𝘆 - 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
🔹𝗧𝗲𝘀𝘁𝗶𝗰𝘂𝗹𝗮𝗿 𝘃𝗼𝗹𝘂𝗺𝗲 - 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
🔹𝗚𝗲𝗻𝗲𝘁𝗶𝗰𝘀 - 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
Klinefelter’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
🔹𝗔𝗴𝗲 - 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
🔹𝗖𝗿𝘆𝗽𝘁𝗼𝗿𝗰𝗵𝗶𝗱𝗶𝘀𝗺 - 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
🔹𝗩𝗮𝗿𝗶𝗰𝗼𝗰𝗲𝗹𝗲 - 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

ℹ️Several studies in the literature report 𝘀𝘂𝗰𝗰𝗲𝘀𝘀𝗳𝘂𝗹 𝘀𝗽𝗲𝗿𝗺 𝗿𝗲𝗰𝗼𝘃𝗲𝗿𝘆 𝘄𝗶𝘁𝗵 𝘀𝗮𝗹𝘃𝗮𝗴𝗲 𝗺𝗶𝗰𝗿𝗼-𝗧𝗘𝗦𝗘 𝗮𝗳𝘁𝗲𝗿 𝗳𝗮𝗶𝗹𝗲𝗱 𝗰𝗼𝗻𝘃𝗲𝗻𝘁𝗶𝗼𝗻𝗮𝗹 𝗧...
10/05/2021

ℹ️Several studies in the literature report 𝘀𝘂𝗰𝗰𝗲𝘀𝘀𝗳𝘂𝗹 𝘀𝗽𝗲𝗿𝗺 𝗿𝗲𝗰𝗼𝘃𝗲𝗿𝘆 𝘄𝗶𝘁𝗵 𝘀𝗮𝗹𝘃𝗮𝗴𝗲 𝗺𝗶𝗰𝗿𝗼-𝗧𝗘𝗦𝗘 𝗮𝗳𝘁𝗲𝗿 𝗳𝗮𝗶𝗹𝗲𝗱 𝗰𝗼𝗻𝘃𝗲𝗻𝘁𝗶𝗼𝗻𝗮𝗹 𝗧𝗘𝗦𝗘.

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.

➡️𝗦𝗽𝗲𝗿𝗺 𝘄𝗮𝘀 𝘀𝘂𝗰𝗰𝗲𝘀𝘀𝗳𝘂𝗹𝗹𝘆 𝗿𝗲𝗰𝗼𝘃𝗲𝗿𝗲𝗱 𝗶𝗻 23 𝗼𝗳 125 (18,4%) 𝗺𝗲𝗻 𝘄𝗶𝘁𝗵 𝗿𝗲𝗽𝗲𝗮𝘁𝗲𝗱 𝗺𝗶𝗰𝗿𝗼-𝗧𝗘𝗦𝗘.

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.

‼️When consulting the patients who had a failed Micro TESE, the results from the current study may enable for them 𝘃𝗮𝗹𝘂𝗮𝗯𝗹𝗲 𝗶𝗻𝗳𝗼𝗿𝗺𝗮𝘁𝗶𝗼𝗻 𝗯𝗲𝗳𝗼𝗿𝗲 𝘁𝗵𝗲 𝗱𝗲𝗰𝗶𝘀𝗶𝗼𝗻 𝘁𝗼 𝗿𝗲𝗽𝗲𝗮𝘁 𝗺𝗶𝗰𝗿𝗼 𝗧𝗘𝗦𝗘.

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

Dr.Vakalidis wishes you health and peaceful holidays!

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