Testicular tumors,the common solid tumors in males of reproductive age,are often associated with spermatogenic failure,among which non-obstructive azoospermia(NOA)is the most severe.This single-center retrospective case series enrolled 10 patients with testicular tumors complicated by NOA from September 2016 to July 2021.The objective is to elucidate the efficacy and safety of the stepwise microsurgical resection of testicular tumors coupled with sperm extraction and cryopreservation.Following thorough preoperative assessment,all patients underwent initial microsurgical testis-sparing surgery for testicular tumors,with the decision for radical orchiectomy based on intraoperative conditions.Simultaneously,microdissection testicular sperm extraction was performed to preserve fertility.The mean age of the 10 patients was 31.9 years(SD=8.24),and the average maximum tumor diameter was 20.70 mm(SD=9.23).Eight patients underwent testis-sparing surgery,while 2 opted for radical surgery.Ultimately,sperm retrieval and cryopreservation were successful in 7 patients.Postoperative pathology revealed 6 malignant cases and 4 benign cases.Notably,patients with malignant pathology,compared to their benign counterparts,had a higher likelihood of a history of cryptorchidism and exhibited a higher sperm retrieval rate(83.3％vs.50.0％,P=0.008).During the follow-up of44.70 months(SD=22.72),no significant postoperative complications,local recurrences,or distant metastases were observed.The stepwise microsurgical resection of testicular tumors,coupled with sperm retrieval,effectively preserved patients'fertility.Moreover,no tumor recurrence was observed during the follow-up,underscoring the procedure's efficacy and safety.
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