Azoospermia and Sperm Retrieval in Post-Pubertal Testicular Torsion; Benefits and limitations

OBJECTIVES To assess the risk of azoospermia development and the value of sperm retrieval in post-pubertal testicular torsion (TT).MATERIALS AND METHODS This prospective study included patients with post-pubertal TT. Surgical exploration was urgently per-formed with either orchiopexy or orchiedectomy and contralateral orchiopexy. With the intention of cryopreservation, all cases underwent conventional testicular sperm extraction. Patients were fol-lowed-up after 1, 3, and 6 months with semen analysis and hormonal assay (FSH, LH and testoster-one). Sperm retrieval rate (SRR), azoospermia rate and changes in hormonal profile were evaluated.RESULTS The study included 62 patients with a median (IQR) age of 19 (18-20.7) years and duration of tes-ticular torsion of 32.5 (18.3-48) hours. Testicular salvage was successful in 20 (32.3%) while orchiedectomy was performed on 42 patients. The duration of torsion [OR, 95% CI = 0.75 (0.61-0.93), P = .008] was the independent predictor of testicular salvage. Successful SR was achieved in 58 patients (93.5%); (40 from the affected testis and 18 from the contralateral side). After 6 months, 21 patients (33.8%) developed azoospermia [19 (45.2%) in orchidectomy group and 2 (10%) in orchiopexy group, P = .006]. Abnormal contralateral testis was the independent predic -tor of azoospermia [OR, 95% CI = 92(8.4-101.5), P < .001]. Azoospermia patients showed a statis-tically significant increase in FSH and LH and decrease in testosterone level as compared to the non-azoospermia group (P < .001).CONCLUSION Azoospermia is not rare in post-pubertal TT patients; therefore, SR at time of intervention seems to be a good option for them to preserve their fertility potentials. UROLOGY 171: 121-126, 2023.& COPY; 2022 Elsevier Inc.

Automated summary

This study aimed to assess the risk of azoospermia development and the value of sperm retrieval in post-pubertal testicular torsion (TT). The results showed that successful sperm retrieval was achieved in most patients, but after 6 months, 33.8% of patients developed azoospermia.