Microdissection OncoTESE (micro-oncoTESE) in azoospermic men with suspected testicular cancer: Analysis of outcomes from an eUROGEN centre
BAUS ePoster online library. Kaul A. 11/10/20; 304187; P6-12
Mr. Asheesh Kaul
Mr. Asheesh Kaul
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Microdissection OncoTESE (micro-oncoTESE) in azoospermic men with suspected testicular cancer: Analysis of outcomes from an eUROGEN centre

Kaul A1, Alnajjar H1, Katelaris A1, Haider A2, Freeman A2, Muneer A1,3,4
1Institute of Andrology, Department of Urology, University College London Hospital, United Kingdom, 2Department of Pathology, University College London Hospital, United Kindgom, 3NIHR Biomedical Research Centre, London, United Kingdom, 4Division of Surgery and Interventional Science, UCL, London, United Kindgomr

Introduction:
Patients diagnosed with azoospermia and testicular lesions suspicious for cancer can be offered a surgical sperm retrieval (SSR) and orchidectomy simultaneously. Microsurgical retrieval of seminiferous tubules in the tumour harboring testicle (micro-onco-TESE) proceeding to a micro-dissection TESE(mTESE) in the contralateral testicle can be offered. The aim of this study was to report a single centre experience.

Methods:
A retrospective cohort study was conducted for azoospermic men undergoing orchidectomy (radical/partial) with concurrent micro-onco-TESE. Intraoperative ex-vivo microsurgical SSR was performed using 18-24X magnification adjacent to the tumour or in vivo mTESE from the contralateral testicle. The primary outcome measure was surgical sperm retrieval rate.

Results:
A total of 33 patients, median age of 33 years (range 24-36) underwent micro-onco-TESE. Testicular cancer (TC) was confirmed in 26 patients and benign pathology in 7 patients. The overall SSR rate was 39%. Sub-analysis showed that the SSR rate was 46% in the TC group and 14% in the benign group (not statistically significant, p=0.20). There was no significant difference in maximum tumour length between successful and unsuccessful SSR groups 33.9mm +/- 23 (SD) vs. 29.8mm +/- 17.5 (SD) p=0.62. There was no significant difference in maximum tumour length to testis length ratio between the successful SSR and unsuccessful groups 0.62+/-0.26 (SD) vs. 0.57+/-0.21 (SD) p=0.59.

Conclusions:
We present one of the largest cohorts of micro-onco-TESE in testicular cancer. The technique should be offered to azoospermic men undergoing surgery for suspicious testicular lesions and our results show an overall SSR rate of 39%.
Microdissection OncoTESE (micro-oncoTESE) in azoospermic men with suspected testicular cancer: Analysis of outcomes from an eUROGEN centre

Kaul A1, Alnajjar H1, Katelaris A1, Haider A2, Freeman A2, Muneer A1,3,4
1Institute of Andrology, Department of Urology, University College London Hospital, United Kingdom, 2Department of Pathology, University College London Hospital, United Kindgom, 3NIHR Biomedical Research Centre, London, United Kingdom, 4Division of Surgery and Interventional Science, UCL, London, United Kindgomr

Introduction:
Patients diagnosed with azoospermia and testicular lesions suspicious for cancer can be offered a surgical sperm retrieval (SSR) and orchidectomy simultaneously. Microsurgical retrieval of seminiferous tubules in the tumour harboring testicle (micro-onco-TESE) proceeding to a micro-dissection TESE(mTESE) in the contralateral testicle can be offered. The aim of this study was to report a single centre experience.

Methods:
A retrospective cohort study was conducted for azoospermic men undergoing orchidectomy (radical/partial) with concurrent micro-onco-TESE. Intraoperative ex-vivo microsurgical SSR was performed using 18-24X magnification adjacent to the tumour or in vivo mTESE from the contralateral testicle. The primary outcome measure was surgical sperm retrieval rate.

Results:
A total of 33 patients, median age of 33 years (range 24-36) underwent micro-onco-TESE. Testicular cancer (TC) was confirmed in 26 patients and benign pathology in 7 patients. The overall SSR rate was 39%. Sub-analysis showed that the SSR rate was 46% in the TC group and 14% in the benign group (not statistically significant, p=0.20). There was no significant difference in maximum tumour length between successful and unsuccessful SSR groups 33.9mm +/- 23 (SD) vs. 29.8mm +/- 17.5 (SD) p=0.62. There was no significant difference in maximum tumour length to testis length ratio between the successful SSR and unsuccessful groups 0.62+/-0.26 (SD) vs. 0.57+/-0.21 (SD) p=0.59.

Conclusions:
We present one of the largest cohorts of micro-onco-TESE in testicular cancer. The technique should be offered to azoospermic men undergoing surgery for suspicious testicular lesions and our results show an overall SSR rate of 39%.
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