The classification of azoospermia into obstructive or non-obstructive is largely based on medical history, physical examination and biochemical markers in serum and semen. However, the most accurate parameter for diagnosis is the testicular histology. The predictive value of the percutaneous epididymal sperm aspiration (PESA), FSH, LH, testosterone, inhibin-B and testicular volume was investigated for their accuracy to predict a complete spermatogenesis (Johnsen score > or =8) in order to replace the testicular histology. The specificity and sensitivity of FSH, inhibin-B, LH, testosterone, testicular volume, and the presence of sperm in a PESA procedure was evaluated in 147 azoospermic males attending the centre for infertility diagnosis. A positive PESA outcome presented the highest sensitivity and specificity to predict a Johnsen score > or =8 (93 and 94% respectively) compared with FSH (90 and 19%), inhibin-B (88 and 57%) and testicular volume (95 and 45%). Differences in clinical presentation were observed between patients with positive sperm retrieval with PESA, depending on the aetiology of obstruction. In conclusion, the presence of spermatozoa in the epididymis (PESA+) correlates with a Johnsen score > or =8 and is the most accurate parameter to predict complete spermatogenesis compared with clinical or biochemical parameters. Between obstructive azoospermic patients, the clinical parameters observed varied according to the aetiology.

译文

:无精子症分为阻塞性或非阻塞性的主要依据是病史,体格检查以及血清和精液中的生化指标。但是,最准确的诊断参数是睾丸组织学。研究了经皮附睾精子抽吸术(PESA),FSH,LH,睾丸激素,抑制素B和睾丸体积的预测价值,以预测其完整精子发生的准确性(Johnsen评分>或= 8),以替代睾丸组织学。 。在147名参加不育症诊断中心的无精子症男性中,评估了PESH程序中FSH,抑制素-B,LH,睾丸激素,睾丸体积和精子的存在的特异性和敏感性。与FSH(90%和19%),抑制素B(88%和57%)和睾丸体积(95)相比,PESA阳性结果预测Johnsen评分>或= 8的敏感性和特异性最高(分别为93%和94%),B抑制素(88%和57%)。和45%)。根据梗阻的病因,在PESA精子检出阳性的患者之间观察到临床表现的差异。总之,附睾中的精子(PESA)的存在与Johnsen评分>或= 8相关,并且与临床或生化指标相比,它是预测完全精子发生的最准确参数。在阻塞性无精子症患者之间,观察到的临床参数根据病因而有所不同。

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