To demonstrate the intraoperative surgical techniques required for a simultaneous radical orchiectomy and microscopic onco-testicular sperm extraction (m-OncoTESE) in step- by-step fashion.
Video presentation.
University hospital (University of Chicago).
A 37-year-old male (status post right orchiectomy at another institution for stage II-C testicular seminoma with positive preoperative tumor markers) was referred for contralateral orchiectomy for multifocal left testis mass and fertility preservation. Semen analysis prior, microTESE during, and semen/testicular specimen analysis post the first orchiectomy, was unable to identify any sperm. A postoperative analysis of the m-OncoTESE performed on the left testis resulted in the cryopreservation of 200,000 motile sperm for future assisted reproductive technology (i.e. IVF or IVF-ICSI).
Left radical orchiectomy, left microscopic onco-testicular sperm extraction.
A comprehensive visual documentation of m-OncoTESE surgical techniques, with concurrent commentary detailing the reasoning behind each surgical step. A brief discussion on the background of m-OncoTESE and alternative fertility preservation methods accompanies the procedure.
This video provides a step-by step guide for performing a m-OncoTESE (proceeding a radical orchiectomy in a testicular cancer patient) as a means of fertility preservation in an azoospermic patient. Successful extraction and cryopreservation of testicular spermatozoa was achieved post-targeted ex-vivo testicular microdissection.
Sperm extraction via m-OncoTESE is a viable option for azoospermic testicular cancer patients undergoing radical orchiectomies. The use of preoperative imaging and microsurgical techniques facilitate and optimize surgical dissection and sperm recovery.
Fertility and sterility. 2024 Feb 23 [Epub ahead of print]
Christopher K Villota, Sean W Hou, Clark Judge, Scott Eggener, Gladell Paner, Omer A Raheem
Pritzker School of Medicine, University of Chicago, Chicago, IL, USA. Electronic address: ., Pritzker School of Medicine, University of Chicago, Chicago, IL, USA. Electronic address: ., Department of Surgery, Section of Urology, University of Chicago, Chicago, IL, USA. Electronic address: ., Department of Surgery, Section of Urology, University of Chicago, Chicago, IL, USA. Electronic address: ., Department of Pathology, University of Chicago, Chicago, IL, USA. Electronic address: ., Department of Surgery, Section of Urology, University of Chicago, Chicago, IL, USA. Electronic address: .