Comparison of sperm retrieval rate between superficial and deep dissection during microscopic testicular sperm extraction.

Objective: The purpose of the study was to compare the outcome of microscopic testicular sperm extraction (micro-TESE) between superficial and deep dissection on the same testicle in terms of sperm retrieval rate (SRR). Patients and Methods: In a retrospective study from June 2019 to October 2021, 44 patients with nonobstructive azoospermia who underwent micro-TESE with positive results (mature sperm identified) were included. Eight patients were excluded from the study due to deficient documentation on superficial and deep dissection. A total of 36 patients were included; 60 testicles were examined for superficial and deep biopsies. Testicular histopathology was performed in all patients, and a hormonal evaluation was obtained before the micro-TESE attempt. Results: Thirty-six patients and 60 testicles were included in the study. Of them, 47 (78.3%) testicles had positive results. Superficial TESE was positive in 38 (63.3%) testicles, and deep TESE was successful in 45 (75.0%) testicles. An improvement of 13.9% in the SRR was observed, following deep dissection. However, there was no statistically significant difference (P = 0.166). Rates of positive sperm retrieval (from any side) did not differ significantly based on patients' age, microdissection testicular sperm extraction sides, and hormonal concentrations; these differences were not apparent after superficial or deep TESE. Conclusion: The presented findings suggest that although successful SRRs of deep TESE were higher than that of its superficial counterpart, there was no significant statistical difference. A larger body of evidence is needed to provide a higher grade of recommendation.

Thrombosis of the superficial dorsal penile vein following aggressive sexual intercourse: A case report.

Penile Mondor's disease is a rare condition characterized by superficial dorsal vein thrombosis of the penis, whose pathogenesis remains unclear. Prolonged or aggressive sexual intercourse has been identified as a potential risk factor. We present a case of a 54-year-old man who developed a penile mass following aggressive sexual activity. Diagnosis of superficial dorsal vein thrombosis was made using ultrasound and confirmed by MRI. The patient underwent conservative treatment and abstained from sexual activity. After four weeks, complete resolution of the thrombus was observed. This case emphasizes the importance of healthcare professionals, particularly urologists, in recognizing and managing Penile Mondor's disease.