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Testicular sperm extraction (TESE) |
The testis is the organ which produces sperms (spermatogenesis). It produces also the male hormone testosterone. Azoospermia is the condition when man is infertile and his semen contains no sperms. The causes for this condition are either obstruction of the seminal ducts, vas deferens, failure of production or maturation of the sperms inside the testicular tissues.
The exact cause is reached through operative interference to winn a sample of the testicular tissue (biopsy) for its histological examination, freezing and exclusion of eventual hidden cancer at the same setting.
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Before surgery
B = biopsy / T = testis
E = epididymis / Vd = spermatic cord
The incision is small,
the sample is taken in layers (sandwich technique).
I = average
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Who qualifies for the operation?
Patients who are fail to have a child within one year of trial where there are no sperms in their semen provided that their hormone profile is within normal range.
How does the operation function?
The patien lyes on his back. The scrotum is injected with local anaesthesia in the vicinty of the vas deferens and testicular vessels. A small incision in the middle of the srotum is done. The testis is exposed and opened over 2 mm incision. 3-5 samples of its tissues are taken and put in a special medium. The procedure is repeated on the other side through the same incision. The wound is closed. And dressed.
Incision
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Frequentely asked questions (FAQ):
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- Why is testicular biopsy useful, inspite of having no sperms on seminal analysis?
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Sperma develop from the testicular cells. The samples are examined under microscope to see if there are sperms if any and to which stage they are developed. This is important for takind decision for the intera cytoplasmic injectin (ICSI) of sperms inside the developed egg of the the wife.
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- Can the doctor use the extracted sperms for fertilization of an egg?
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Yes, when the sperm is developed to a certain stage. It is then possible to isolate it and inject it microscopicaly into the egg.
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- Is there any danger that the testis may not produce sperms anymore after the operation or may develpe cancer?
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No, the function of the testis remains the same and it is not liable to develop cancer thereafter.
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- Does the operation influence my sexuality and my ability for erection?
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Not at all. Your sexuality, production of sperms and hormones stay the same after the operation.
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- Are there any risks for the operation?
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TESE is a simple operation in experienced hands. It implies no special risk. The risks which may happens are the same as for any minor procedure on the testis which are rare. These are mainly bleeding, infection, difficult healing of the wound.
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