JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018 - 38

Journal of Clinical Urology 11(1S)

P3-11:Table 5. The incidence of post-operative urinary
symptoms in 2,496 men at follow up following urethroplasty,
and the magnitude in improvement in those symptoms from
the pre-operative state.

P3-12 Is there a role for salvage or redo
micro-dissection testicular sperm extraction
in non-obstructive azoospermia?

Urinary symptoms

Post-op Improvement from
Incidence pre op. incidence

Obstructive
Post-micturition dribble
Storage urinary symptoms
Spraying
Pain on voiding
Infective / inflammatory

8.7%
7.5%
4.8%
3.2%
0.6%
1.8%

Morris S1, Yap T1, Alkematy K2, Bhandari C2, Garraffa
G2, Sangster P2, Shabbir M1, Minhas S2
1Guy's and St. Thomas' NHS Foundation Trust, London, United
Kingdom, 2University College Hospital, London, United Kingdom

9 fold
3 fold
4 fold
4 fold
17 fold
12 fold

P3-11: Table 6. The incidence of new sexual symptoms,
in 1,981 men having had urethroplasty, and the magnitude in
improvement in the same symptom from the pre-operative state.
Sexual symptom

Post-op
Incidence

Improvement from
pre op. incidence

Erectile dysfunction (ED)
Ejaculatory dysfunction
Penile cosmesis/bend

5.4%
1.7%
0.25%

3 fold
7 fold
28 fold

P3-11: Table 7. Urine flow rates, in 1,753 men at outpatients
following urethroplasty dependent upon surgical site. Only 2 men
having bladder neck reconstruction had a flow rate post-operatively.
Stricture repair site

Urine flow rate (mls/sec)
<5

Bulbo-prostatic
Bulbar
Peno-bulbar
Penile
Meatal & Navicular fossa
All sites

6-10

11-15 16-20 >20

5.4% 15.2% 15.2% 22.9%
0.9% 4.2% 9.6% 18.3%
4%
8% 18.4% 23.6%
1.3% 6.6% 18.3% 24%
0.7% 6.1% 14.6% 16.9%
1.6% 5.6% 12.2% 19.8%

41.3%
67%
46%
49.8%
61.7%
60.8%

P3-11: Table 8. Percentage of 4,091 men presenting with
stricture disease having documented recurrence at follow-up.
Stricture repair site

Overall recurrence rate

Bladder neck
Bulbo-prostatic
Bulbar
Peno-bulbar
Penile
Meatal & Navicular fossa

8.5%
10.2%
2.2%
4.2%
2.1%
1.1%

Introduction: Microdissection testicular sperm extraction (micro-TESE) is an increasingly favoured method of
surgical sperm retrieval (SSR) for non-obstructive azoospermia (NOA). Increasingly, patients present for repeat
SSR after previous failed or successful SSR. This study
reviews the success of repeat micro-TESE and explores
predictors of successful retrieval.
Patients and Methods: 153 patients underwent repeat
micro-TESE. Group 1- salvage after previous failed cTESE or
TESA (n=123); Group 2- repeat after previous successful
cTESE or TESA (n=14); Group 3- salvage after previous
failed micro-TESE (n=9); Group 4- repeat after previous successful micro-TESE (n=7). Analysis of clinical predictive factors for successful salvage or redo SSR was also performed.
Results: The mean (range) patient age was 37 (22-57).
Overall repeat micro-TESE was successful in 45%. Success
rates were: Group 1; 39% (48/123), Group 2; 79% (11/14),
Group 3; 33% (3/9), Group 4; 100% (7/7) in Group 4. Only
the presence of hypospermatogenesis was significantly
associated with successful SSR in the salvage or redo setting (p=0.013). Age, serum hormones and testicular size
were not statistically significant predictors of success.
There were no reported cases of testicular atrophy or loss.
Conclusion: Repeat micro-TESE is safe and the success
rate of 45% is close to the reported primary SSR success
rates in NOA. In the repeat setting sperm is found again in
79-100% of cases, while in the salvage setting sperm is still
seen a third of cases, indicating that men with NOA could
still have further SSR in carefully selected cases especially
if hypospermatogenesis was seen on initial pathology.
P3-13 A UK multicentre study analysing
the surgical sperm retrieval rates in men
with non-mosaic klinefelter's syndrome
undergoing mTESE

P3-11: Table 9. The urine flow rates and incidence of
documented recurrence in 1,763 men at outpatient review.
Peak Urine Flow rate

Number of cases

Incidence of
recurrence

<5mls/sec
6 - 10 mls/sec
11 - 15 mls/sec
16 - 20 mls/sec
> 20 mls/sec

24
99
215
348
1,077

54%
30.3%
4.1%
0.9%
1%

Hallerstrom M1, Johnson M1, Sangster P1, Raheem A1,
Zainal Y1, Poselay S1, Johnson T1, Mohammadi Amr
Moubasher B1, Hafez K1, Bhandari C1, Vincens A1, Yap
T1, Shabbir M1, Minhas S1, Ralph D1
1University College London Hospital, United Kingdom

Introduction: A contemporary meta-analysis (Corona
et al, 2017) has demonstrated that the surgical sperm
retrieval rates (SSR) in men with Klinefelter's syndrome
(KS) undergoing TESE are approximately 50% worldwide.
A number of confounding variables including demographic,
clinical and biochemical factors may affect SSR. The aim of

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