Treatment

PESA (Percutaneous Epididymal Sperm Aspiration)

Percutaneous Epididymal Sperm Aspiration (PESA) is a sperm retrieval technique where a needle is inserted into the epididymis to collect sperm, often used in cases of obstructive azoospermia (lack of sperm in ejaculate) to assist with IVF or ICSI. 

Here's a more detailed explanation:

• Why is it used? 

  • PESA is used in cases where a blockage in the vas deferens prevents sperm from being ejaculated. 
  • This can be caused by factors like previous vasectomy, infections, genetic conditions, or other conditions. 
  • PESA is often used as a sperm retrieval method in conjunction with IVF or ICSI. 

• How does it work? 

  • A needle is inserted through the scrotal skin into the epididymis. 
  • The surgeon uses a syringe to create negative pressure, aspirating the sperm-containing fluid. 
  • The sperm are then analyzed and can be used for fertility treatments like ICSI or cryopreserved for future use. 

• Success rates and comparison to other methods 

  • PESA has a good success rate in retrieving sperm, especially in cases of obstructive azoospermia. 
  • Some studies show PESA can be as effective as microsurgical epididymal sperm aspiration (MESA) for sperm retrieval and ICSI outcomes. 
  • PESA is generally considered to be a less invasive and faster procedure than MESA. 

• Possible Complications 

  • PESA is generally considered safe, but potential complications could include mild pain, or a vasovagal reflex (dizziness or fainting). Local anaesthesia or sedation can be used to minimise any pain during the procedure.

• What is PESA? 

  • The procedure is typically performed under local anesthesia or sedation. 
  • PESA can be a simple, quick and effective method to retrieve sperm in men with obstructive azoospermia. 
  • PESA involves using a fine needle to aspirate sperm-containing fluid from the epididymis, a coiled tube that stores and matures sperm. 

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