PESA stands for Percutaneous Epididymal Sperm Aspiration. This procedure involves the use of a fine needle in order to extract sperm cells from the epididymis of the males who want to have a biological child of their own. The process is done in the operating room under the action of local anaesthesia. Percutaneous Epididymal Sperm Aspiration is least invasive, and loss of blood is minimal in this procedure when compared to other methods used for sperm extraction. The extracted fluid is further examined by an embryologist to check for motility and quantity of sperm cells.
Aim of PESA in azoospermia:
As the name suggests Percutaneous Epididymal Sperm Aspiration is the process of retrieval of sperm through direct injection of a fine needle into the epididymis of the male and extracting the sperm from the epididymis. The strategy for the decision of sperm recovery (SR) depends on the sort of azoospermia, which can be obstructive or non-obstructive, and the specialist's inclinations and experience. Obstructive azoospermia (OA) is related to the failure of recognizing the spermatozoa in the ejaculate and post-ejaculate urine after centrifugation because of the two-sided check of the fundamental pipes. It also aims to collect the best and ideal quality sperm from the collected sperm cell. Collecting enough sperms for cryopreserving
Need for PESA:
Males with the following conditions may require to undergo Percutaneous Epididymal Sperm Aspiration:
Varicocele- This condition is portrayed by harmless testicular cysts that might emerge from a mass of varicose veins shaping inside the spermatic line or epididymis. This might cause blockages that will influence the progression of sperm out of the gonads and epididymis. To recover sperm from a man experiencing this condition, then, at that point, PESA will work best.
Azoospermia- In this condition, the man’s discharge contains no sperm, representing somewhere in the range of 10% and 15% of the reasons for male barrenness. This could be because of blockage in the sperm conveyance framework or a decrease in how much sperm is delivered in the testicles is produced. PESA is the most successful and least invasive treatment for obstructive azoospermia.
Testicular failure- Because of chromosomal irregularities brought about by conditions, for example, Klinefelter’s disorder or different anomalies of the Y chromosome, a man might encounter testicular failure. This problem diminishes the capacity of the gonads to deliver and store sufficient sperm that can advance into the lady’s uterus during discharge. For this situation, PESA or TESA might be utilized to gather any sperm that might be in the epididymis or testicles for IVF.
How to prepare yourself before undergoing PESA:
Get a good sleep a night before the surgery.
Avoid blood-thinning medicines 4-5 days before the surgery.
Clean the area with disinfectant and antibacterial soap in order to remove any infections or bacterial growth.
Get an experienced doctor who has expertise in sperm aspiration procedures so that no complications occur during the time of operation.
The male is introduced with local anaesthesia before the operation which means that the procedure remains painless.
The testis is examined by the doctor so that the location of the epididymis may be confirmed.
Sperm extraction is then done with the help of a fine needle which is introduced into the epididymis of the male undergoing the surgery.
The extracted sperms are examined by an embryologist to ensure their quality and motility.
The procedure is usually followed by cryopreservation of sperms and ICSI.
Care after the operation:
The male who has undergone Percutaneous Epididymal Sperm Aspiration is generally discharged within hours after the surgery so bring a family member or your partner with you.
Avoid eating heavy meals for a few days after the surgery.
Although the procedure of PESA is the least invasive still use of gauze pads to cover the scrotal region should be continued for 2-3 days after coming from the hospital.
Some pain or swelling in the scrotal region will be relieved by the medicines prescribed by the doctor after the treatment.
Always consult the doctor before resuming sexual activities after the operation.
Benefits of Percutaneous Epididymal Sperm Aspiration:
PESA has many benefits and is considerably more acceptable to patients who ordinarily return to work the following day and who for the most part have no tension regarding its reoccurrence. On the off chance that sperm can't be found in the epididymis the doctor then, at that point, continues to a Testicular Sperm Aspiration (TESA). The procedure of PESA is painless and always performed under localised anaesthesia. Loss of blood is also minimum during the process. When done by an experienced and dedicated doctor who has expertise in this field, the procedure is fast, smooth and cleanly done. Always consider going to a doctor who has had successful past experiences in these kinds of sperm aspiration surgeries as this procedure needs an ample amount of experience and expertise.
Success Rate of PESA:
PESA has great success rates as compared to the other procedures aiming to achieve obstructive azoospermia. It is effective in almost 100% of the cases if there are sperms present within the epididymis and you have the right medical guidance.