PESA is the least invasive way of sperm retrieval which is highly effective in retrieving sperms in obstructive azoospermia. Procedure is done in operation theatre with a very fine needle. PESA is a day care procedure with almost no requirement of home rest post procedure.
TESE (Testicular Sperm Extraction) -: In patients of azoospermia testicular sperms can be retrieved with the help of tissue removed from testis. The testicular tissue can be taken out by minimally invasive procedure with the help of needle. Success rate of this procedure is high in obstructive azoospermia. TESE is a day care procedure and patient usually don’t need rest after surgery.
Microscopic Sperm Retrieval or Micro TESE is a highly effective way of sperm retrieval in which under high magnification with the help of microscope good tissue in testis is searched for sperms. In this procedure testis is cut opened and good tissue containing sperms are searched. Once the sperms are found in tissue removed from the testis the testis closed. Patient is discharged next day morning. Dressing is removed after 48 hours. Patient can return for daily activity after 2 days. Strenuous activity is avoided for 2 weeks.
Microscopic correction of varicocele is the standard procedure with higher success rates than any other method. This procedure is done with very high magnification under microscope. Higher magnification helps to reduce the chance of recurrence and injury to testicular artery. Higher magnification also prevents hydrocele after surgery. Improvement in sperm count as well as pregnancy rate is higher in microscopic technique. Patient can be discharged on the same day and after one day rest he can rejoin his work.
Blockage of last part of ejaculatory duct which enters in prostate causes infertility. There can be complete blockage leading to azoospermia or partial blockage causes poor motility sperms. The blockage can be surgically corrected by an endoscopic procedure.
Vasectomy is common procedure opted by about 13-14 % married men as a form of contraception. Due to various causes 2 to 6 % of these men will desire for reversal for vasectomy. Reason to revert back to fertility include re-marriage, desire for further fertility because of loss of a child. Vasectomy reversal is highly specialised and skilful surgery done with the help of operating microscope under 25 to 30 times magnification. Success rate is far better with higher magnifications.
Vasoepididymal anastomosis helps patients with obstructive azoospermia to attain fertility and natural pregnancy. This surgery is done under operating microscope, as fine tubules are joined to form a bypass for the obstruction. Success rates depends on level of obstruction and fine anastomosis under magnification. Patient will need one day rest and scrotal support for a fortnight. He need to do semen analysis every 3 months after surgery. This procedure is particularly helpful for young couples with good fertility potential.