\u00dcroloji Uzman\u0131 Dr. \u00d6\u011fr. \u00dcyesi Muhsin Balaban, azospermi hastalar\u0131n\u0131n bebek sahibi olabilece\u011fini s\u00f6yledi.<\/p>\n
Azospermi, menide sperm h\u00fccresine rastlanmamas\u0131na deniliyor. \u0130ki \u00e7e\u015fiti bilinen hastal\u0131\u011f\u0131n birincisi sperm \u00fcretimi var ama spermin meniye ula\u015fmas\u0131n\u0131 engelleyen bir t\u0131kan\u0131kl\u0131k mevcut. \u0130kinci \u00e7e\u015fidinde ise testis i\u00e7erisinde sperm \u00fcretimi yok. Azospermi hastalar\u0131n\u0131n bebek sahibi olabilece\u011fini s\u00f6yleyen Medicana International \u0130stanbul Hastanesi \u00dcroloji Uzman\u0131 Dr. \u00d6\u011fr. \u00dcyesi Muhsin Balaban, hastal\u0131k hakk\u0131nda \u00f6nemli bilgiler verdi. Dr. Balaban, infertil erkeklerin y\u00fczde 10\u2019unda ve t\u00fcm erkeklerin y\u00fczde 1\u2019inde azospermi durumu oldu\u011funu belirtti.<\/p>\n
\u2019\u2019Kemoterapi ila\u00e7lar\u0131 ve radyasyon tedavisi riski art\u0131r\u0131r\u2019\u2019<\/p>\n
Azospermiye neden olan bir\u00e7ok sebebin oldu\u011funu belirten Dr. Muhsin Balaban, \u2019\u2019Genetik hastal\u0131klardan kliniferter sendromu, kemoterapi ila\u00e7lar\u0131, radyasyon tedavisi, narkotik benzeri ila\u00e7lar, varikosel hastal\u0131\u011f\u0131, do\u011fu\u015ftan sperm ta\u015f\u0131yan kanallar\u0131n yoklu\u011fu gibi durumlar azospermine neden olabilmektedir. \u00c7o\u011fu hastada genellikle bir sebep bulunamaz, do\u011fu\u015ftan testisin geli\u015fmemi\u015f olmas\u0131 ya da \u00e7evresel zararl\u0131 maddelere maruziyet de azospermiye neden olabilmektedir. Azoperm saptand\u0131\u011f\u0131nda bunun sebebinin kanal t\u0131kan\u0131kl\u0131\u011f\u0131ndan m\u0131? Yoksa testisin \u00fcretim bozuklu\u011fundan m\u0131? Oldu\u011funu anlayabiliriz. Y\u00fczde 100 olmamakla birlikte hastan\u0131n fizik muayenesinden ve kandaki hormonlar\u0131ndan (FSH, \u0130nhibin B) bir fikir elde edilebilir. Eskiden azospermik hastalar\u0131n hepsine testis biyopsisi yap\u0131l\u0131rken, g\u00fcn\u00fcm\u00fcz prati\u011finde bu yakla\u015f\u0131m terk edilmi\u015ftir. \u00c7\u00fcnk\u00fc sperm bulmak i\u00e7in yap\u0131lan Mikro TESE ameliyat\u0131nda ayn\u0131 testiste baz\u0131 alanlarda hi\u00e7 sperm \u00fcretecek h\u00fccre yok iken (Sertoly cell only) baz\u0131 alanlarda ise sperm \u00fcretiminin yetersiz oldu\u011fu (hipospermatogenez ya da maturasyon arrest) g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Bu y\u00fczden azospermik hastalara yap\u0131lan testis biyopsisi genel yakla\u015f\u0131m\u0131 de\u011fi\u015ftirmemektedir ve MikroTESE i\u015flemi \u00f6nerilmektedir\u2019\u2019 diye konu\u015ftu.<\/p>\n
\u2019\u2019Tedavide partnerin ya\u015f\u0131 \u00f6nemlidir\u2019\u2019<\/p>\n
Azospermi olan hastalarda tedaviyi planlarken bir\u00e7ok fakt\u00f6r\u00fc g\u00f6z \u00f6n\u00fcne al\u0131nmas\u0131 gerekti\u011fini dile getiren Dr. Balaban, \u2019\u2019\u00d6ncelikle partnerin ya\u015f\u0131, gelecekle ilgili beklentiler, hastan\u0131n hormon tahlilleri ve fizik muayene bulgular\u0131 tedaviyi \u015fekillendirmektedir. E\u011fer hasta vazektomi operasyonu olmu\u015fsa ilk yap\u0131lacak \u015fey; vaz\u0131n tekrardan d\u00fczeltilmesidir. Hastan\u0131n kulland\u0131\u011f\u0131 uyar\u0131c\u0131 ila\u00e7lar var ise kesilmelidir. Hastada hormonal yetmezlik var ise (pituiter yetmezlik gibi) hormon tedavisi uygulanarak sperm \u00fcretimi sa\u011flanabilir. Belirgin varikosel var ise sadece varikoselin d\u00fczeltilmesi sperm \u00fcretimini ba\u015flatabilir. Bu sebepler d\u0131\u015f\u0131ndaki hastalarda zaman kaybetmeden testis i\u00e7inde sperm arama i\u015flemi (Mikro TESE) yap\u0131lmal\u0131 ve \u00fcremeye yard\u0131mc\u0131 teknikler uygulanmal\u0131d\u0131r. Bu i\u015flem yap\u0131l\u0131rken doktorun tecr\u00fcbesi, e\u011fitimi ve yeterlili\u011fi g\u00f6z \u00fcn\u00fcne al\u0131nmal\u0131d\u0131r. Ger\u00e7ekten de \u00e7ok say\u0131da Mikro TESE i\u015flemi yapan doktorun ba\u015far\u0131s\u0131 daha fazla olmaktad\u0131r\u2019\u2019 \u015feklinde konu\u015ftu.<\/p>\n
\u2019\u2019Hastanede kalma s\u00fcresi k\u0131sad\u0131r\u2019\u2019<\/p>\n
Dr. Balaban, konu\u015fmas\u0131n\u0131 \u015f\u00f6yle sonland\u0131rd\u0131: \u2019\u2019D\u00fcnya \u00fczerinde \u00e7ok say\u0131da \u00e7ift azospermik oldu\u011fu halde \u00fcst paragrafta anlat\u0131lan y\u00f6ntemlerle \u00e7ocuk sahibi olmu\u015ftur ve hayallerine kavu\u015fmu\u015flard\u0131r. Obstr\u00fcktif azospermi i\u00e7in sperm bulma y\u00f6ntemleri birden \u00e7oktur. Bunlar TESE, TESA ve MESA\u2019d\u0131r. Nonobstr\u00fcktif azospermide sperm bulma \u015fans\u0131 en y\u00fcksek olan Mikro TESE y\u00f6ntemi kullan\u0131lmaktad\u0131r. Bu y\u00f6ntemde hastanede g\u00fcn\u00fcbirlik yat\u0131\u015f olmaktad\u0131r. Mikroskop kullan\u0131ld\u0131\u011f\u0131 i\u00e7in sadece sa\u011fl\u0131kl\u0131 g\u00f6r\u00fclen t\u00fcb\u00fcller se\u00e7ilerek al\u0131nmaktad\u0131r ve testisin testosteron \u00fcreten h\u00fccrelerine zarar verilmemektedir. Bu i\u015flem lokal anestezi alt\u0131nda yap\u0131labilir ama i\u015flemin baz\u0131 vakalarda uzayabilece\u011finden ve hasta fakt\u00f6r\u00fc g\u00f6z \u00f6n\u00fcne al\u0131nd\u0131\u011f\u0131nda genel anestezi alt\u0131nda yapmak daha uygun bir se\u00e7enek olarak \u00f6n\u00fcm\u00fcze gelmektedir\u2019\u2019.<\/p>\n","protected":false},"excerpt":{"rendered":"
\u00dcROLOJ\u0130 UZMANI DR. \u00d6\u011eR. \u00dcYES\u0130 MUHS\u0130N BALABAN, AZOSPERM\u0130 HASTALARININ BEBEK SAH\u0130B\u0130 OLAB\u0130LECE\u011e\u0130N\u0130 S\u00d6YLED\u0130.<\/p>\n","protected":false},"author":1,"featured_media":196562,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2},"jetpack_post_was_ever_published":false},"categories":[1],"tags":[49373,2123,67,5897,5966],"class_list":["post-196561","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-genel","tag-azospermi","tag-bebek","tag-hastalari","tag-olabilir","tag-sahibi"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/www.tvturk.com\/wp-content\/uploads\/2019\/08\/azospermi-hastalari-da-bebek-sahibi-olabilir_5a27c4f.jpg?fit=666%2C1000","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/paKIfm-P8l","_links":{"self":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/196561","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/comments?post=196561"}],"version-history":[{"count":0,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/posts\/196561\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media\/196562"}],"wp:attachment":[{"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/media?parent=196561"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/categories?post=196561"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.tvturk.com\/index.php\/wp-json\/wp\/v2\/tags?post=196561"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}