Human Reproduction, Vol 13, 3390-3393, Copyright © 1998 by Oxford University Press
R Ron-El, S Strauss, S Friedler, D Strassburger, D Komarovsky and A Raziel
Percutaneous epididymal sperm aspiration (PESA), percutaneous testicular
sperm aspiration (TESA) and testicular sperm extraction (TESE) are invasive
procedures and their consequences on the testis have not been clearly
defined. In order to relate the sonographic and colour Doppler flow changes
to the clinical data, 14 patients with non- obstructive and six with
obstructive azoospermia were examined by the same roentgenologist
immediately before, at 5 days, 2 weeks, 2 and 6 months after the surgical
procedure. Testicular volumes remained unchanged during the follow-up
period in both the non-obstructive and obstructive groups. Of the
non-obstructive group, focal testicular lesions were seen in 20 of the 26
testes (77%) 5 days after the procedure and in 54% by 6 months. Ten were
hypoechoic, of which six converted to echogenic foci, three remained
hypoechoic and one disappeared at 6 months. The other 10 were echogenic
lesions, three of which were no longer visible at 6 months and the
remainder were unchanged. In the obstructive azoospermic group, focal
lesions were not found. Extratesticular abnormality consistent with
haematoma was demonstrated in four non-obstructive cases, which disappeared
at the 6 month examination, and in none of the obstructive azoospermic
patients. Whether residual focal lesions in the testes have long-term
effects remains to be evaluated. In the obstructive azoospermic group, the
aspirations performed did not leave any sonographic abnormalities.
ARTICLES
Serial sonography and colour flow Doppler imaging following testicular and epididymal sperm extraction
IVF and Infertility Unit, Assaf Harofeh Medical Center, Zerifin, Israel.
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