Sperm may be retrieved from the testis itself, or from a structure that surrounds the testis called the epididymis. If sperm is retrieved from the epididymis then this is done usually with a fine needle placed through the skin and directly into the epididymis called a PESA. It can be performed under local anaesthetic or sedation and occasionally under general anaesthetic. There are minimal complications from a PESA although there may be some bruising in the scrotum and some discomfort. This should resolve after a week, and although strenuous activity should be avoided for a few days, most types of work can be done immediately after the procedure.
If sperm is retrieved from the testis, called TESE, this can either be done through a small cut in the scrotum and a biopsy gun or through a slightly wider cut in the scrotum and an open biopsy. Again, this can be performed under local anaesthetic , sedation or general anaesthetic. There is usually some bruising in the scrotum and some minor discomfort. There is a small chance of infection or testicular damage, but this is rare. Strenuous activity should be avoided for 2 weeks, and only light duties at work would be advised for a few days after the procedure. A scrotal support is given out after the procedure and should be worn for a few days to prevent bruising, but could be exchanged for some tight fitting underpants.
If a microscopic dissection is performed to retrieve sperm then the recovery and post-operative instructions are the same as for TESE as described above. There is a higher chance of a temporary drop in testosterone with microscopic dissection which can make men tired and lacking in energy until this picks up again. This can take several weeks to return to normal.
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Information on sperm retrieval through the British Association of Urological Surgeons can be found here: http://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Sperm%20retrieval.pdf