The following is a summary of “Azoospermia and Sperm Retrieval in Post-Pubertal Testicular Torsion; Benefits and limitations,” published in the JANUARY 2023 issue of Urology by Almekaty, et al.

For a study, researchers sought to determine the probability of developing azoospermia and the usefulness of sperm retrieval in post-pubertal testicular torsion (TT) cases. 

The study included patients who had post-pubertal TT, and the surgical procedure was either orchiopexy or orchiectomy and contralateral orchiopexy. All cases underwent conventional testicular sperm extraction with the aim of cryopreservation. After 1, 3, and 6 months, the patients were monitored through a semen analysis and hormonal assay (FSH, LH, and testosterone). In addition, the sperm retrieval rate (SRR), azoospermia rate, and changes in hormonal profile were analyzed.

The study had 62 patients with a median age of 19 years (with an interquartile range (IQR) of 18-20.7 years) and a testicular torsion duration of 32.5 hours (with an IQR of 18.3-48 hours). Testicular salvage was successful in 20 patients (32.3%), and orchiectomy was performed on 42 patients. The duration of torsion [OR, 95% CI = 0.75 (0.61-0.93), P = .008] was found to be the independent predictor of testicular salvage. Successful sperm retrieval was achieved in 58 patients (93.5%), with 40 from the affected testis and 18 from the contralateral side. After 6 months, 21 patients (33.8%) developed azoospermia [19 (45.2%) in the orchidectomy group and 2 (10%) in the orchiopexy group, P = .006]. An abnormal contralateral testis was identified as an independent predictor of azoospermia [OR, 95% CI = 92(8.4-101.5), P < .001]. Azoospermia patients showed a statistically significant increase in FSH and LH levels and a decrease in testosterone levels compared to the non-azoospermia group (P < .001).

In conclusion, azoospermia is a possible outcome in post-pubertal TT patients. Therefore, sperm retrieval at the time of intervention seemed a good option to preserve fertility potential.

Reference: goldjournal.net/article/S0090-4295(22)00828-7/fulltext