Percutaneous Epididymal Sperm Aspiration (PESA)

Percutaneous Epididymal Sperm Aspiration (PESA) is a process for retrieving sperm from the epididymis (a tube that connects a testicle to a vas deferens in a male reproductive system).

PESA can be performed without a surgical cut in the scrotum. It is a simple, quick, cost-effective technique and can be repeated easily.

The procedure is usually carried out under local or general anesthesia. After induction of anesthesia, the testis is stabilized, and the epididymis is held between the surgeon′s thumb and forefinger. A butterfly needle with a 20 ml syringe is inserted into the caput epididymis and gently withdrawn until fluid can be seen entering the tubing of the aspiration set. After removing the syringe, the tubing is clamped and backflushed with media. This procedure is repeated until enough epididymal fluid with motile sperm is retrieved. If no sperm is retrieved, then it is necessary to proceed with testicular biopsy or testicular aspiration.