(193) Bilateral Onco-TESE and Placement of Bilateral Testicular Prostheses

Abstract

Abstract Introduction Here we present the case of a 36-year-old male who underwent bilateral Onco-TESE (oncologic testicular sperm extraction) and insertion of bilateral testicular prostheses in the setting of bilateral testicular masses and refractor testicular pain. Preoperative evaluation revealed the presence of non-obstructive azoospermia and Klinefelter syndrome. Objective To demonstrate the effectiveness and feasibility of bilateral Onco-TESE as a therapeutic option for the patient with bilateral testicular masses, refractory bilateral testicular pain, non-obstructive azoospermia, and Klinefelter syndrome while attempting to preserve future fertility. Methods A comprehensive diagnostic workup was performed preoperatively including physical examination, scrotal ultrasound, hormonal evaluation, semen analysis, and genetic testing. Informed consent for the procedure and its filming was obtained from the patient prior to undergoing bilateral Onco-TESE and insertion of bilateral testicular prostheses. Results Pathologic analysis of testicular masses revealed Multinodular Leydig cell hyperplasia. The extracted testicular tissue yielded no viable sperm. The patient’s testicular pain resolved after the immediate postoperative period with an excellent cosmetic result. Conclusions This case presentation highlights a unique indication for bilateral Onco-TESE and insertion of bilateral testicular prostheses in a patient with bilateral testicular masses, bilateral testicular pain, Klinefelter syndrome, and desired future fertility. Disclosure No.