Does percutaneous epididymal sperm aspiration actually cause epididymal obstruction?
Lorenzini, F1; Lorenzini, MS2; Cairoli, C3
1: Lorenzini Andrology Center, Brazil; 2: Lorenzini Andrology Center ; 3: Lorenzini Andrology Center
Objectives: To evaluate the sperm in vas deferens fluid (VDF) after percutaneous sperm aspiration of epididymis (PESA) in order to establish whether there was patency of epididymal ducts and what parameter could predict this occurrence.
Material and Method: Ten vasectomized patients after failed ICSI/IVF procedures, using PESA (8 unilateral, 2 bilateral), underwent intraoperative sperm analysis of VDF during their microsurgical vasectomy reversals. The parameters of the study were the age of the patients, the elapsed time between vasectomy and VDF analysis, between PESA and VDF analysis, and the presence, concentration and motility of sperm in VDF.
Results: The mean age of the patients was 47.50 ± 5.48 years (40 - 59). The mean elapsed time between vasectomy and VDF sperm analysis was 17.50 ± 7.58 years (10 - 25). The mean elapsed time between PESA and VDF analysis was 24.60 ± 17.00 months (7 - 54). The VDF analysis showed sperm in 5 patients, with mean concentration of (33.04 ± 24.27) million sperm/ml and motile sperm in 3 patients (progressive: 10%, 5% and <1%, respectively). The mean elapsed time between vasectomy and VDF analysis showed a statistically significant difference between the 5 patients who had sperm in the VDF and 5 who did not have sperm in the VDF (13.80 ± 6.34 and 21.20 ± 7.40 years, respectively, p <0.05).
Conclusions: In 50% of these vasectomized patients, PESA did not cause epididymal obstruction. Moreover, after PESA, the lower elapsed time between vasectomy and its reversal was the best parameter to predict the absence of epididymal obstruction.
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