Purpose: To investigate the relationship between the histopathological findings of testis tissue samples and sperm retrieval success of micro-TESE in non-obstructive azoospermia (NOA) patients. Method: Histopathological examination results of the testis tissue samples of 795 NOA patients who underwent micro-TESE operation in our clinic between 2003 and 2014 were included. Histopathological findings were grouped as hypospermatogenesis, incomplete spermatocytic arrest, complete spermatocytic arrest, Sertoli cell only syndrome (SCOS), and fibrosis/atrophy. Chi-square analysis was used to compare the histopathological findings with the sperm retrieval rates of micro-TESE. Result: Sperm was found in 341 (42,9%) patients following micro-TESE compared to 454(57,1%) patients where sperm were not detected (P < 0.001). Sperm retrieval rates of micro TESE were significantly higher in hypospermatogenesis and incomplete maturation arrest groups (93.2% (P < 0.001) and 72.5% (P < 0.001), respectively). Complete maturation arrest, SCOS and fibrosis/atrophy were determined at significantly higher rates in patients (220.2%) with no sperm found compared to patients with sperm (P < 0.001). Conclusion: The findings of this study are consistent with those of previous studies in the literature. Testicular histopathological findings can provide additional data when informing NOA patients about the expected success of further micro-TESE operations.

Background: Varicocoele is a correctable cause of male infertility. Although physical examination is still being used in diagnosis and grading, it gives conflicting results when compared to ultrasonography‐based varicocoele grading.Objectives: We aimed to develop a multi‐class machine learning model for the grading of varicocoeles based on ultrasonographic measurements.Method: Between January and May 2024, we enrolled unilateral varicocoele patients at an infertility clinic, assessing their varicocoele stages using the Dubin and Amelar system. We measured vascular diameter and reflux time at the testicular apex and the subinguinal region ultrasonography in both the supine and standing positions. Using these measurements, we developed four multi‐class machine learning models, evaluating their performance metrics and determining which patient position and projection were most influential in varicocoele grading.Results: We included 248 patients with unilateral varicocoele in the study, their average age was 26.61 ± 4.95 years old. Of these, 212 had left‐sided and 36 had right‐sided varicocoeles. According to the Dubin and Amelar system, there were 66 grade I, 96 grade II, and 86 grade III varicocoeles. Among the models we created, the random forest (RF) model performed best, with an overall accuracy of 0.81 ± 0.06, an F1 score of 0.79 ± 0.02, a sensitivity of 0.69 ± 0.02, and a specificity of 0.8 ± 0.03.Vascular diameter measurement at the testicular apex in the supine position had the most impact on grading across all models. In support vector machine and multi‐layer perceptron models, reflux time measurements from the subinguinal projection in the standing position contributed the most, while in RF and k‐nearest neighbors models, measurements from the subinguinal projection in the supine position were the most influential.Conclusions: Machine learning methods have demonstrated superior accuracy in predicting disease compared to traditional statistical regressions and nomograms. These advancements hold promise for clinically automated prediction of varicocoele grades in patients. Tailored varicocoele grading for individuals has the potential to enhance treatment effectiveness and overall quality of life.

Introduction: To evaluate the effect of American Society of Anesthesiology (ASA) scores on percutaneous nephrolithotomy (PNL) outcomes. Materials and Methods: The records of 186 consecutive patients undergoing PNL procedures from 2006 to 2011 at a single institution were evaluated. Patients were divided into a low-risk group with a preoperative ASA of I or II and a high-risk group with ASA of III or IV. Postoperative complications were classified according to the modified Clavien classification system. Results and Conclusions: There were 140 cases in the low-risk and 46 cases in the high-risk groups. The mean operative time was 72 min (40–120 min) and 86 min (55–125 min) and the complication rates were 17.8 and 19.5% for the low- and high-risk groups, respectively. The average duration of nephrostomy tube drainage was 3.3 ± 1 and 4.2 ± 1.5 days for the low- and high-risk groups, respectively. Stone-free rates were 85 and 82% for the low- and high-risk groups, respectively. PNL can be safely performed in the ASA high-risk patient population.