Pre-test anxiety levels and postoperative pain in non-obstructive azoospermic patients: Is klinefelter syndrome a predisposing factor?

Abstract

Increased depression and anxiety incidence in infertile individuals treated with assisted reproductive techniques have been shown in studies. Postoperative pain perception after testicular sperm extraction (TESE) is thought to be related to preoperative anxiety in non-obstructive azoospermia (NOA). Twenty patients with Klinefelter syndrome (KS) and twenty male patients with normal karyotype NOA planned for TESE under local anaesthesia due to azoospermia were included in the study. Spielberger State-Trait Anxiety Inventory (STAI-T and STAI-S) inventory was given to all patients 1 h before surgery. Postoperative pain evaluation was performed at 0, 30, 60 and 120 min with visual analogue scale (VAS). STAI-T inventory was given to the patients again 2 h after the procedure. Preoperative STAI-S and STAI-T scores and postoperative STAI-T scores of patients in the KS group were higher than those in the NOA group, and there was a significant difference in the statistical analysis between the two groups (p < 0.001). In the postoperative VAS scores, there was no statistical difference at the 0 and 120th min (p = 0.56 and p = 0.87, respectively); at the 30, 60 and 90th min there was a statistically significant difference between the two groups, especially in patients in the KS group (p < 0.05, p < 0.05, p < 0.01, respectively). The contribution of anxiety to pain perception should be kept in mind in azoospermic male patients before TESE, and additional measures should be taken considering that this may be experienced at a higher level in KS patients.