reproductive medicine
Reproductive surgery for the male partner
In some cases, a biopsy of the testis is needed to retrieve the sperm, the so-called TESE – testicular sperm extraction. In some cases, the surgeon could prefer to do PESA – percutaneous epididymal sperm aspiration.
TESE/PESA
In some cases, spontaneous conception cannot occur due to the absence of spermatozoa in the ejaculate (azoospermia), which can result from various causes – congenital absence of sperm ducts, sperm duct obstruction, some genetic conditions, etc. Absence of sperm in the ejaculate could be caused also by past inflammation, resulting in blockage of the ejaculatory ducts, making impossible the passage of spermatozoa. In such cases, a biopsy of the testis is needed to retrieve the sperm, the so-called TESE – testicular sperm extraction. In some cases, the surgeon could prefer to do PESA – percutaneous epididymal sperm aspiration. The procedure is scheduled on the day of egg retrieval of the female partner, and the surgically retrieved spermatozoa are processed and capacitated using standard IVF protocols.
On the day of the TESE or PESA it is necessary to first visit the Surgery Department admissions office (office 12).
Preparation
- On the day of the procedure, you have to come to the hospital fasting (avoid all food and drink from the previous night)
- You must have removed your genital hair in advance
- Do not forget to bring your ID
Admission and stay
Upon admission, you will be assigned blood tests, and ECG, and consultations with an anaesthesiologist and an internist. The manipulation is a single-day surgical procedure, which means that hospital admission, surgery and discharge are on the same day.
The TESE procedure is done under short sedation and local anaesthesia, and lasts about 15 to 20 minutes.
You can be discharged about two hours after the surgery, but you must visit the hospital on the next day for bandage change. Pain from the intervention is minimal, and usually short-lasting. If you report that you feel pain during your hospital stay, you will be offered pain medication – analgesics and spasmolytics.
The PESA procedure is again done under short sedation, but the procedure only takes 5 minutes. Hospital admission and pre-operative preparation are the same as for TESE.
If a medical history document (discharge summary) is presented as a proof of cancer diagnosis, it is added in the patient’s file and sperm cryopreservation and storage are provided pro bono.