Percutaneous Epididymal Sperm Aspiration
Vasoepididymostomy london andrology

Percutaneous Epididymal Sperm Aspiration (PESA) is a form of surgical sperm removal (SSR).  SSR can be useful in a number of circumstances. This includes couples who wish to try for a baby after a previous vasectomy but vasectomy reversal either isn’t suitable or isn’t desired.  Or when couples are unable to conceive due to a diagnosis of azoospermia due to blockages.

The good news is azoospermia does not automatically mean couples will never be able to conceive.  Instead, there are a number of treatment options available, depending what’s causing the condition.

Percutaneous Epididymal Sperm Aspiration is usually a suitable option for men who have been diagnosed with an obstruction or blockage that’s preventing their sperm from exiting the epididymis.  In other words, sperm is being produced in the testes.  It just isn’t able to exit the man’s body.  PESA is also an option for men who wish to try for another pregnancy following a previous vasectomy.

How is Percutaneous Epididymal Sperm Aspiration performed?

Percutaneous Epididymal Sperm Aspiration is a minimally invasive surgical sperm removal technique, essentially involving extracting sperm directly from the epididymis, via very fine needle and light suction.  The sperm will be analysed before being frozen. It’s usually possible to get a generous sample with a single PESA procedure and outcomes are generally positive.

If appropriate, PESA can be carried out with local anaesthetic used to temporarily numb the area, so no pain is felt.  This means you’ll be able to go home shortly afterwards.  Plus there are less risks involved compared with more invasive procedures that require general anaesthetic.

Because PESA is a relatively minor and minimally invasive surgical technique, recovery time is generally quick and straightforward.  However, some tenderness after the procedure is normal, so you may need to take it easy for a few days.  Regular painkillers are required, and wearing a scrotal support/supportive underwear can definitely help.  You’ll also be advised to wait until the area is healed before resuming sexual intercourse and vigorous exercise.  This can often be just a period of a few days.

Risks and success rates of PESA

All surgical procedures carry a degree of risk, including the risk of infection and bleeding.  While these are generally minimal, it is important to be fully informed.  Any risks and positive outcomes of the procedure will always be discussed with the patient before going ahead.

In addition, it is essential to remember that there is no guarantee that PESA will result in a successful sperm extraction or pregnancy.  However, if the treatment is deemed suitable for you, outcomes are generally good.

Alternatives to PESA

At London Andrology we offer a number of surgical sperm retrieval techniques. Which technique is most suitable largely depends on individual circumstances and why the treatment is required.  If you are having difficulty conceiving, we can help you by investigating and diagnosing the root causes of the problem and talk you through the treatment options.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

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