The efficacy of local anaesthesia for percutaneous epididymal sperm aspiration and testicular sperm aspiration

Abstract

A total of 37 percutaneous epididymal sperm aspiration (PESA) and/or testicular sperm aspiration (TESA) procedures were performed under local anaesthesia (LA) on 34 men between June and November 1996. Local anaesthesia was achieved by injecting 10 ml of 1% lignocaine solution along the sides of the vas deferens near the external inguinal ring (spermatic cord block). Sperm retrieval was successful in 92% of the procedures. Of the 37 procedures, in 29 the patients felt either no pain or mild discomfort while in six they experienced moderate but tolerable pain. Analgesia was incomplete in two procedures and was supplemented with i.v. sedation. Vasovagal reflex in two procedures was reversed by i.v. atropine. In 24 procedures patients felt relaxed, whilst in 13 they felt anxious. In 32 procedures the patients expressed overall satisfaction. If the procedure was to be repeated, after 29 procedures the patients requested LA again, while after four procedures they preferred i.v. sedation and after four were undecided. LA is adequate for PESA and TESA in a large proportion of patients. Prior discussion of LA technique with the patient is necessary. Back-up facilities for i.v. sedation and atropine should be available.

Large-needle percutaneous aspiration biopsy of the testicle in men with nonobstructive azoospermia

“…A spermatic cord block was accomplished by injecting 5-7 mL of 2% lidocaine with a 23-G needle (3). A few minutes later, the testicle was manually immobilized, and LNAB was performed with a syringe holder, 20-mL syringes, and an 18-, 20-, 21-, or 22-G needle.…”

Efficacité et innocuité du prélèvement percutané de sperme testiculaire dans la prise en charge de l’infertilité masculine

“…L'aspiration percutanEe de sperme Epididymaire (PESA) est une option efficace dans le cas d'obstruction ne relevant pas d'une cure chirurgicale; elle peut ~tre rEalisEe sous anesthEsie locale [4] et peut fournir une bonne quantitE de sperme [17], mais n'est pas faisable chez les patients avec ANO.…”

“…L'Extraction PercutanEe de Sperme Testiculaire (PTESE) est une technique attirante puisqu'elle est facile h apprendre, peut ~tre rEalisEe sous anesthEsie locale [4], est bien tolErEe, et fournit assez de materiel pour faire une ICSI et m~me la cryoprEservation de sperme [13,19] first 15 patients in the series and percutaneous biopsy was performed on an outpatient basis, under local anesthesia, with a Biopty Gun~ (14G needle), in the subsequent patients as the first step in management. Open surgical biopsies were performed in another 15 patients following a sperm cell-negative percutaneous biopsy.…”

Y-chromosome microdeletions in nonobstructive azoospermia and severe oligozoospermia

“…The open testicular biopsy for sperm extraction was performed with spermatic cord block 2324. For tissue preparation, small testicular seminiferous tubule fragments were fragmented and squeezed, and the resultant fluid fraction was treated according to a previous described protocol using erythrocyte-lysing buffer and enzymatic digestion with DNase and collagenase 2526.…”