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High prevalence of urogenital infection/inflammation in patients with azoospermia does not impede surgical sperm retrieval

Andrologia Sep 05, 2019

Pilatz A, Kilb J, Kaplan H, et al. - Via a prospective study of 71 patients with azoospermia subjected to an extensive andrological workup involving comprehensive microbiological diagnostics and testicular biopsy/testicular sperm extraction (TESE), researchers made a comprehensive assessment of the prevalence of urogenital tract infection/inflammation and its potential influence on sperm retrieval in azoospermic patients who underwent testicular biopsy/TESE. In 7% of patients, medical history suggested urogenital tract infection/inflammation, 11% harbored STIs, 14% exhibited notable bacteriospermia, 15% had seminal inflammation, 17% achieved the male accessory gland infection definition, and 27% had appropriate pathogens. At the testicular level, one patient had a swab positive for bacteria, no viruses were identified, tissue specimens never intimated pathogens, whereas, in 23% of samples, histopathology exhibited focal immune cell infiltrates. In obstructive and in nonobstructive azoospermia, the testicular sperm retrieval rate was 100% and 46%, respectively. None of the infection/inflammation-related variables was related to the success of sperm retrieval or inflammatory lesions in the testis. Among azoospermic men, the high prevalence of urogenital infection/inflammation underpins their role as important etiologic factors in male infertility. Nonetheless, this conclusion does not lead to the possibility of sperm retrieval at the time of surgery/TESE.
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