Modified stepwise mini-incision microdissection testicular sperm extraction: a useful technique for patients with a history of orchidopexy affected by non-obstructive azoospermia.

Non-obstructive azoospermia (NOA), which is defined as the absence of spermatozoa in the ejaculate secondary to impaired spermatogenesis within the testis, may be caused by a variety of etiologies, including varicocele-induced testicular damage, cryptorchidism, prior testicular torsion, post-pubertal mumps orchitis, gonadotoxic effects from medications, genetic abnormalities, chemotherapy/radiation, and other unknown causes currently classified as idiopathic (Cocuzza et al., 2013). The microdissection testicular sperm extraction (micro-TESE) technique involves a meticulous microsurgical exploration of the testicular parenchyma to identify and selectively extract larger seminiferous tubules that carry a higher probability of complete spermatogenesis (Schlegel, 1999). The Cornell group evaluated the efficacy of micro-TESE in 152 NOA patients with an associated history of cryptorchidism. In their series, spermatozoa were successfully retrieved in 116/181 attempts (64%), and the resulting pregnancy rate was 50% with a delivery rate of 38% (Dabaja and Schlegel, 2013). Franco et al. (2016) described a stepwise micro-TESE approach in NOA patients, which was considered to reduce the cost, time, and effort associated with the surgery. Alrabeeah et al. (2016) further reported that a mini-incision micro-TESE, carried through a 1-cm equatorial testicular incision, can be useful for micro-TESE candidates, particularly in patients with cryptozoospermia. We conducted a retrospective study of 20 consecutive NOA patients with a history of orchidopexy from May 2015 to March 2017.

Association of testicular p63 expression and spermatogenesis in androgen receptor knockout (ARKO) mice.

OBJECTIVE: To study changes of testicular p63 expression and its effect on spermatogenic function in seminiferous tubules in androgen receptor knockout (ARKO) mice. METHODS: A total of 28 ARKO mice (ARKO group) screened by Cre-lox and 28 male Wistar mice without ARKO (controlled group) were enrolled in our study. Route pathology was performed and p63 examination was detected by immunohistochemistry in testes. Linear correlations were used to explore potential associations between p63 protein expression and spermatogenic function (TMS score). RESULTS: In ARKO group, inner diameter of seminiferous tubules was decreased (62 +/- 1.3 microm vs. 91 +/- 1.2 microm), thickness of the basal membrane of the tubules (4 +/- 0.3 microm vs. 2.7 +/- 0.5 microm), cellular population within tubules was reduced (2 +/- 0.4 vs. 4 +/- 0.1 layers), degree of spermatogenesis within the tubules turned to disturbance (3 +/- 1.0 vs. 5 +/- 0.1), Testicular Makler score was lower than controlled group (7 +/- 0.2 vs.15 +/- 0.3), they had significant differences (p <0.01). P63 expressed significantly lower in ARKO group than that in Wistar group, and was limited at stages from spermatocyte to round spermatid. (Percentage of positive cells ? 68.1 +/- 3.7 vs. 81.7 +/- 5.1, p<0.001). The HSCORE yielded similar results (HSCORE 3.7 +/- 0.3 vs. 2.0 +/- 0.2, p<0.001). p63 protein expression was significantly positively correlated with spermatogenic function (r=0.87, p<0.01). CONCLUSIONS: p63 developed important effect on spermatogenesis and the regulatory effect of p63 on spermatogenesis mainly occurred in the early stage of spermiogenesis in testis.

[Improved experimental varicocele increases follicle-stimulating hormone and reduces inhibin B in rats].

OBJECTIVE: To evaluate the effects of improved experimental left varicocele (ELV) on follicle-stimulating hormone (FSH) and inhibin B (InhB). METHODS: ELV models were established by the improved method in 30 SD rats, and another 30 were included in a sham operation group as controls. Three months after the operation, the concentrations of the FSH and InhB were assayed by ELISA. RESULTS: The concentration of FSH in the serum was significantly higher in the experimental group ([37.56 +/- 9.72] ng/ml) than in the control ([26.69 +/- 5.33] ng/ml) (P < 0.05), while that of InhB significantly lower in the former ([349.93 +/- 99.48] pg/ml) than in the latter ([768. 83 +/- 146.96] pg/ml) (P < 0.05). CONCLUSION: Improved ELV can increase FSH and reduce InhB in rats, which may be associated with subfertility.

[Mitochondrial function score combined with Gleason score for predicting the progression of prostate cancer].

OBJECTIVE: To evaluate the mitochondrial function score in combination with Gleason score in predicting the progression of prostate cancer. METHODS: This study included twenty 58-79 (70.1 +/- 1.2) years old patients with prostate cancer treated by radical prostatectomy. The epithelioglandular mitochondrial function scores of the patients were obtained under the transmission electron microscope and assessed according to Flameng grading. Meanwhile, their Gleason scores were analyzed and, based on the scores, the patients were divided into Groups I (Gleason score: 2 -4) and II (Gleason score: 5 -7). RESULTS: The mitochondrial function score of Group I was significantly different from that of Group II (4.0 +/- 0.8 versus 2.3 +/- 0.6, P < 0.05), with a negative correlation with the Gleason score (r = -0.793, P < 0.05). One year follow-up showed a significantly lower mortality in Group I (0/8) than in Group II (6/12) (P < 0.05). CONCLUSION: Mitochondrial dysfunction exists in prostate cancer patients, particularly in those with higher malignancy. The mitochondrial function score combined with Gleason score plays a valuable role in predicting the progression of prostate cancer.