{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T12:54:04Z","timestamp":1781182444196,"version":"3.54.1"},"reference-count":30,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: To compare surgical outcomes and sperm retrieval rates (SRRs) between conventional microsurgical-assisted testicular sperm extraction (m-TeSE\u2014Group A) and testicular sperm extraction performed with surgical loupes (l-TeSE\u2014Group B) in adult males with non-obstructive azoospermia (NOA). Methods: A multicentric prospective randomized trial (ethics committee no. 202\/2022) in accordance with the CONSORT guidelines was conducted from March 2022 to April 2024. Adult males with NOA without genetic alterations who signed the informed consent were enrolled. SRRs, intra- and postoperative complications (according to the Clavien\u2013Dindo classification), and hormonal profile changes were considered as outcomes during the follow-up period. Results: A total of 42 NOA patients were enrolled. The median age was 35 years (IQR: 33\u201349). The preoperative median FSH was 16.5 mIU\/mL (IQR: 11.6\u201322.5) and the total testosterone was 4.6 (3.5\u20135.6). Overall, the SRR was 22.6%, with sperm retrieved from 19 testes. Histopathological findings reported Sertoli cell-only syndrome (SCOS) in 46.4% (39 cases), hypospermatogenesis in 26.2%, and germ cell arrest in 26.2% of the patients. No intraoperative complications were recorded. The postoperative complications were minimal (Clavien\u2013Dindo grade I), but no significant differences were recorded in-between the two surgical approaches. Considering the operative time of the testicular exploration alone, Group B seemed to be faster than the m-TeSE, with a median time saving of 8 min (p &lt; 0.01). Conclusion: The use of surgical loupes was safe and comparable with m-TeSE in terms of the SRRs and complication rates. L-TeSE offered a reduction in the operative time compared with m-TeSE.<\/jats:p>","DOI":"10.3390\/jcm14030970","type":"journal-article","created":{"date-parts":[[2025,2,4]],"date-time":"2025-02-04T05:55:22Z","timestamp":1738648522000},"page":"970","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Preliminary Results of Microsurgical Sperm Retrieval in Azoospermic Patients: A Randomized Controlled Trial Comparing Operating Microscope vs. Surgical Loupes"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8144-6498","authenticated-orcid":false,"given":"Mirko","family":"Preto","sequence":"first","affiliation":[{"name":"Urology Clinic, A.O.U. \u201cCitt\u00e0 della Salute e della Scienza\u201d, Molinette Hospital, University of Turin, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Boeri","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Ca\u2019 Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8732-4272","authenticated-orcid":false,"given":"Lorenzo","family":"Cirigliano","sequence":"additional","affiliation":[{"name":"Urology Clinic, A.O.U. \u201cCitt\u00e0 della Salute e della Scienza\u201d, Molinette Hospital, University of Turin, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1101-892X","authenticated-orcid":false,"given":"Marco","family":"Falcone","sequence":"additional","affiliation":[{"name":"Urology Clinic, A.O.U. \u201cCitt\u00e0 della Salute e della Scienza\u201d, Molinette Hospital, University of Turin, 10126 Torino, Italy"},{"name":"Neurourology Clinic, A.O.U. \u201cCitt\u00e0 della Salute e della Scienza\u201d, Unit\u00e0 Spinale Unipolare, 10126 Turin, Italy"},{"name":"Department of Surgical Sciences-Urology, Citt\u00e0 della Salute e della Scienza di Torino, University of Turin, 10126 Torino, Italy"},{"name":"Department of Urology, School of Medicine, Biruni University, 34015 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Parolin","sequence":"additional","affiliation":[{"name":"IRCCS Fondazione Ca\u2019 Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Peretti","sequence":"additional","affiliation":[{"name":"Urology Clinic, A.O.U. \u201cCitt\u00e0 della Salute e della Scienza\u201d, Molinette Hospital, University of Turin, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Ferro","sequence":"additional","affiliation":[{"name":"Urology Clinic, A.O.U. \u201cCitt\u00e0 della Salute e della Scienza\u201d, Molinette Hospital, University of Turin, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Plamadeala","sequence":"additional","affiliation":[{"name":"Urology Clinic, A.O.U. \u201cCitt\u00e0 della Salute e della Scienza\u201d, Molinette Hospital, University of Turin, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Scavone","sequence":"additional","affiliation":[{"name":"Urology Clinic, A.O.U. \u201cCitt\u00e0 della Salute e della Scienza\u201d, Molinette Hospital, University of Turin, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Zupo","sequence":"additional","affiliation":[{"name":"Urology Clinic, A.O.U. \u201cCitt\u00e0 della Salute e della Scienza\u201d, Molinette Hospital, University of Turin, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Gontero","sequence":"additional","affiliation":[{"name":"Urology Clinic, A.O.U. \u201cCitt\u00e0 della Salute e della Scienza\u201d, Molinette Hospital, University of Turin, 10126 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/S0022-5347(17)38662-7","article-title":"Evaluation of the Azoospermic Patient","volume":"142","author":"Jarow","year":"1989","journal-title":"J. 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