Is Learning Curve Short for MicroTESE Operation in Nonobstructive Azoospermic Patients?

Abstract

Aim: To evaluate learning curve in microdissection testicular sperm extraction (microTESE) surgery performed in non-obstructive azoospermia patients. Material and Method: The study included 300 non-obstructive azoospermic (NOA) patients, who underwent microTESE surgery performed by a single urologist. The patients were divided into three groups (the first 100 patients, the second 100 patients, and the third 100 patients) and these groups were compared in terms of sperm retrieval rate (SRR) and other clinical parameters. It was planned to compare the patients in first 99 patients between themselves in case there is no difference between the groups in terms of SRR. Results: The overall SRR was 47% in 300 NOA patients. No significant difference was determined between the three groups in terms of SRR (49%, 46%, and 46%, respectively). Accordingly, the first 99 patients were re-compared in terms of SRR (the first 33 patients, the second 33 patients, and the third 33 patients). It was observed that there is also no significant difference between these groups in terms of SRR (54.5%, 42.4%, and 51.5%, respectively). Moreover, no significant difference was determined between all of the groups in terms of patient age, testis volume, and serum follicle-stimulating hormone and testosterone levels. It was observed that duration of surgery has been significantly shortened in all groups as the number of surgical procedures increased. Discussion: Learning curve in microTESE surgery is shorter according to learning curves in other urological surgeries.