TeSE stands for Testicular Sperm Extraction. This is performed again under sedation or a general anaesthetic as a day case procedure. TeSE can be open or closed. Vision can be enhanced through using a microscope.

Closed TeSE

TeSE can be done with a biopsy gun that takes a needle biopsy of the testis. This is done through a tiny cut in the scrotum. Normally 4 biopsies from each testis are taken. The tiny incision is sprayed to seal it at the end and does not normally require a stitch.

Open TeSE

TeSE can also be performed by making a cut in the scrotum and making 4 tiny cuts in each testis. This removes a larger quantity of testicular tissue. The tiny cuts are closed with a stitch and the cut in the scrotum is closed with a dissolvable stitch. This is also done as a day case. 

Microscopic TeSE

Microscopic dissection TeSE is performed through the same size cut in the scrotum as for the open TeSE. The testis is opened up so that the tubules, where sperm are produced, can be identified. The tubules are very small and so a microscope is used to identify areas where sperm production is more likely. Results suggest that in cases where sperm production is patchy, this technique offers the best chance of success. It can be performed as a day case under a general anaesthetic.