I-Shen Huang

Distinguishing non-obstructive azoospermia from obstructive azoospermia in Taiwanese patients by hormone profile and testis size

Background: An accurate diagnosis of the etiology of azoospermia is crucial, as sperm retrieval methods differ between patients with non‐obstructive azoospermia (NOA) and obstructive azoospermia (OA). The aim of this study was to determine hormone and testes size cutoff values to identify the cause of azoospermia in Taiwanese patients. Methods: The medical records of azoospermic patients were retrospectively collected from April 2008 to July 2016, including hormone profile, physical examination findings, and testes size. Bilateral testes biopsies or microdissection testicular sperm extraction were performed in all patients for a definite diagnosis. The diagnostic parameters used to distinguish NOA from OA were analyzed using the t‐test and receiver operating characteristic curves. Results: A total of 51 patients with OA and 156 with NOA were included. The mean levels of testosterone (4.5 vs. 3.4 ng/ml) and E2 (26.3 vs. 19.2 pg/ml) were significantly higher in the OA group, whereas the levels of follicular stimulating hormone (FSH) (5.6 vs. 25.4 mIU/ml) and Leutinizing hormone (LH) (3.7 vs. 11.6 mIU/ml) were lower. Receiver operating characteristic curve analysis revealed that FSH and right testis size were the best individual diagnostic predictors. Using a combination of FSH >9.2 mIU/ml and right testis size <15 ml, the positive predictive value for NOA was 99.2% and 81.8% for OA. Conclusion: A combination of FSH >9.2 mIU/ml and right testis size <15 ml was a strong predictor of NOA in our Taiwanese patients.

Patients with chronic periodontitis are more likely to develop upper urinary tract stone: a nation-wide population-based eight-year follow up study

Background The purpose of this study was to investigate the relationship between chronic periodontitis (CP) and upper urinary tract stone (UUTS) in Taiwan by using a population-based data set. Methods A total of 16,292 CP patients and 48,876 randomly-selected controls without chronic periodontitis were selected from the National research database and studied retrospectively. Subjects selected have not been diagnosed with UUTS previously. These subjects were prospectively followed for at least eight years. Cox regression models were used to explore the connection between risk factors and the development of UUTS. Results The CP patients have a greater chance of developing UUTS compared to controls (1761/16292, 10.8% vs. 4775/48876, 9.8%, p-values < 0.001). Conditioned logistic regression suggested CP increases the risk of UUTS development (HR 1.14, 95% CI [1.08–1.20], p < 0.001). After respective adjustment for age, gender, hypertension and diabetes, results showed that CP still increases the risk of developing UUTS (HR 1.14, 95% CI [1.08–1.20], p < 0.001). Conclusion By using a population-based database with a minimum eight 8 follow-up of CP in Taiwan, we discovered patients with CP are more likely to develop UUTS.

PD68-05 THE OUTCOMES OF SCROTAL EXPLORATION WITH VASOEPIDIDYMOSTOMY IN PATIENTS WITH NON-IATROGENIC, NON-TRAUMATIC OBSTRUCTIVE AZOOSPERMIA

RESULTS: A total of 198 men (mean age 35 8 years) were included. Fertilization and pregnancy rates were 44% and 38%, respectively. On univariable analysis, sperm motility and the lack of acrosome defects were associated with higher fertilization and pregnancy rates while an increasing number of total sperm abnormalities was negatively associated with fertilization, but not pregnancy, rates (Table). On MVA, only sperm motility was associated with fertilization rates (p<0.001) while both sperm motility (p1⁄40.004) and the lack of acrosome abnormalities (p1⁄40.018) were associated with pregnancy rates. Female age (mean age 31 5 years) was not associated with fertilization or pregnancy rates on MVA. CONCLUSIONS: This study is the first to assess the relationship between injected testicular sperm characteristics and reproductive outcomes in ICSI. All men with NOA have abnormal sperm morphology and our experience suggests that no specific sperm abnormality, including injection of non-motile sperm, precludes the chance of pregnancy. Further study of sperm characteristics may influence how aggressively surgeons should seek better sperm quality during microTESE procedures. Use of elongating spermatids (blunt-tailed sperm) did not adversely affect the chance of pregnancy despite concerns for lower fertilization with severely blunt-tailed sperm.

Correlation between Bladder Neck Mobility and Voiding Phase Urodynamic Parameters in Female Patients with Stress Urinary Incontinence

The correlation between bladder neck mobility (BNM) and voiding function in females has not been examined before. This study investigated the correlation between BNM and voiding phase urodynamic parameters in female patients with stress urinary incontinence (SUI).