EXTRAGENITAL PATHOLOGY AND CLINICAL SYMPTOMS IN MEN WITH PATHOSPERMIA

Abstract The most difficult form of male infertility to treat is azoospermia. Azoospermia is defined as the complete absence of spermatozoa in the ejaculate. The age of the patients who underwent clinical and diagnostic studies varied between 22 and 45 years. Among 119 examined patients with azoospermia, 69 (58.0%) were diagnosed with secretory infertility. In 50 (42.0%) patients, the presence of spermatogenesis in excretory-obturational infertility was established. Among 69 patients with secretory infertility, 23 had azoospermia in the absence of spermatozoa and spermatogenic cells, which accounted for 33.3% of all patients with secretory infertility (in particular, 2 with leukocytospermia, which indicated damage to the tubular apparatus as a result of previous orchitis). In 46 (66.6%) patients, azoospermia was observed in the absence of spermatozoa, but in the presence of precursor cells of spermatogenesis. Eight (11.6%) patients out of 69 (group 1) were diagnosed with concomitant diseases. We see that arterial hypertension, diseases of the gastrointestinal tract, liver, and kidneys occur. Hereditary diseases were not detected in the examined patients. One (4.3%) patient suffered from viral orchitis, one (4.3%) had an operation for phlegmon of the portcullis, three (13.0%) suffered from non-viral epididymitis, four underwent bilateral orchopexy at an early age. Pain of varying intensity was found in 6.7% of patients, varying degrees of testicular hypoplasia were found in 7.6%, dysuria in 13.4%, epididymitis in history - 8.4%; history of epidemic mumps - 6.7; 12.6% had depression, restlessness, sleep disorders, and 21.0% had erectile dysfunction. According to clinical examination and ultrasound, chronic prostatitis is suspected in 19.2% of patients. An increase in the number of leukocytes in the blood was found in 15 (13.2%) patients.References: 1. Horpinchenko II, Romaniuk MG. Male infertility: etiology, pathogenesis, diagnosis and modern methods of treatment. Men's Нealth. 2016;1(56):8-11. 2. Bostwick DG. Urologic surgical pathology. 3th edition. 2014. 976 p. 3. Salonia A, Bettocchi C, Carvalho J, Corona G, Jones TH. et al. EAU Guidelines on sexual and reproductive health. European Association of Urology. 2022:251. 4. Nieschlag E, Behre HM, Nieschlag S. Andrology. Male reproductive health and dysfunction. 3rd еd. Berlin; Heidelberg: Springer-Verlag. 2010. 5. Aitken RJ. Impact of oxidative stress on male and female germ cells: implications for fertility. Reproduction. 2020;159:189–201. 6. Bernie AM, Shah K, Halpern JA et al. Outcomes of microdissection testicular sperm extraction in men with nonobstructive azoospermia due to maturation arrest. Fertil Steril. 2015;104:569-573. 7. Cissen M, Meijerink AM, D'Hauwers KW et al. Prediction model for obtaining spermatozoa with testicular sperm extraction in men with non-obstructive azoospermia. 2016;31:1934-1941. 8. Dohle GR, Elzanaty S, van Casteren NJ. Testicular biopsy: clinical practice and interpretation. Asian J Androl. 2012;14(1):88-93. 9. Esteves SC. Microdissection testicular sperm extraction (micro-TESE) as a sperm acquisition method for men with nonobstructive azoospermia seeking fertility: operative and laboratory aspects. Int Braz J Urol. 2013;39:440-446. 10. Ghalayini I, Al-Ghazo MA, Hani OV et al. Clinical comparison of conventional testicular sperm extraction and microdissection techniques for non-obstructive azoospermia. J Clin Med Res. 2011;3(3):124-131. 11. Hao L, Li ZG, He HG et al. Application of percutaneous epididymal sperm aspiration in azoospermia. Eur Rev Med Pharmacol Sci. 2017;21:1032-1035. 12. Abdulwahed SR, Mohamed EE, Taha EA, Saleh MA et al. Sensitivity and specificity of ultrasonography in predicting etiology of azoospermia. Urology. 2013;81(5):967-971