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Biopsia testicular percutánea pronóstica en pacientes con varicocelectomía
Resumen
Introducción: el varicocele es la principal causa reversible de subfertilidad. El objetivo fue evaluar la utilidad de la biopsia testicular percutánea en el pronóstico de fertilidad de pacientes a los que se les practicó varicocelectomía simultáneamente.
Material y métodos: se evaluó tasa de embarazos y resultados de espermatobioscopia en 50 pacientes distribuidos en cinco grupos de acuerdo con el daño testicular determinado por biopsia testicular percutánea. Se empleó ANOVA y prueba exacta de Fisher.
Resultados: la edad de los pacientes fue de 30.3 ± 5 años. La densidad espermática y la motilidad mejoraron después de un año de la varicocelectomía. Se lograron embarazos a los 13 ± 9 meses después; 15 pacientes embarazaron a su pareja y sólo uno tenía daño histológico IV. La probabilidad de embarazo fue mayor cuando el hombre mostró daño testicular estadios I a III (OR = 9.3, IC 95 % = 11-79, p < 0.021).
Conclusiones: la clasificación histológica propuesta ayuda a la evaluación cualitativa de la magnitud del daño testicular en pacientes subfértiles con varicocele y a pronosticar la fertilidad una vez sometidos a varicocelectomía.
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