Comparison of Classic Transverse Incision MicroTESE and Modified Mini-Incision MicroTESE in Non-Obstructive Azoospermic Patients.

INTRODUCTION

Non-obstructive azoospermia (NOA) is primarily due to impaired spermatogenesis. Microdissection testicular sperm extraction (mTESE) is the gold standard for sperm retrieval in NOA patients. We compared sperm retrieval rates (SRR), operative time, and postoperative outcomes between classic transverse incision microTESE (CTI) and modified mini-incision microTESE (MMI).

METHODS

In this retrospective study, 59 men with NOA underwent either CTI (n = 33) or MMI (n = 26) between 2021 and 2024. Preoperative and postoperative parameters, including SRR, operative time, complications, testosterone levels, testicular volume, and histopathology, were analyzed. Statistical analyses were performed using IBM SPSS Statistics version 21.

RESULTS

SRR was 34.6% in MMI and 39.4% in CTI (p = 0.706). Operative time (46.5 ± 7.9 min vs. 64.7 ± 14.5 min, p = 0.001) and postoperative pain scores (VAS 2.9 ± 0.7 vs. 4.4 ± 0.5, p = 0.001) were significantly lower in MMI. No complications were observed. Histology revealed Sertoli cell-only syndrome in 14 and 19 patients in MMI and CTI groups, respectively; the remainder had maturation arrest or hypospermatogenesis. No complications such as infection, sperm granuloma, or androgen deficiency were observed in either group.

CONCLUSION

SRR was comparable between techniques. MMI was associated with shorter operative times and reduced postoperative discomfort.