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- W2891290553 abstract "To develop a method with maximally minimized injury and sufficient sperm yield on the basis of the above methods. For obstructive azoospermia (OA), percutaneous epididymis sperm aspiration (PESA), microsurgical epididymal sperm aspiration (MESA), minimally invasive epididymal sperm aspiration (MIESA), mini-micro-epididymal sperm aspiration (mini-MESA), macrosurgical epididymal sperm imprint collection (MESIC) and open fine needle aspiration (OFEN) have been employed to retrieve sperm. In this study, PESA, MESA, MIESA, mini-MESA , MESIC and OFEN were performed for more than 10 cases each method in OA patients. On the basis of comparing the above methods, we developed a modified method of OFEN (MOFEN). MOFEN was performed under local anesthesia with 2% lidocaine in 20 OA patients. A small incision less than 1 cm in length was cut at the position corresponding to epididymis. After epididymis was exposed, the needle tip of tuberculin syringe preloaded with about 0.1 ml of sperm washing medium was pierced through tunica into the epididymal tubule which was seen faintly beneath epididymal tunic under operating microscope at 25X magnification. To minimize injury to epididymal tubule, attention was paid to inserting the needle carefully with the rear of the needle bevel just passed the tunica. Then the tubule fluid was aspitrated. If no cloudy material entered into syringe, the needle was withdrawn a little and inserted again with direction adjusted. After aspiration, the content of the syringe was expelled into a culture plate. Then, the epididymis was squeezed, and the fluid milked out from the needle hole was suctioned with the nipple of the same syringe preloaded with about 0.1 ml of sperm washing medium. If no sperm was found in the aspiration, the needle hole on the epididymal tunic was enlarged as small as possible that just 2 or 3 tubules were exposed. Then, the tubule was pierced and aspirated, and the contents milked out from the needle hole of the tubule was suctioned with the same manoeuvre as described above. The severity of injury ranked from MIESA, MESA to Mini-MESA in microsurgical procedure; MESIC to OFNA in macrosurgical procedure. In PESA, the epididymal tubules were punctured blindly and generally repeatedly, many tubules were injured. Considering the size of the incision and only one tubule was punctured in most condition, MOFNA injuried the least in the study. As to efficiency of sperm retrieval, PESA and MIESA harvested the least and the most, respectively. In MOFNA, sperm retrieval was 100% successful and 20.8X106 sperm were harvested on average. MOFNA is an efficient and safer method for epididymal sperm aspiration." @default.
- W2891290553 created "2018-09-27" @default.
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- W2891290553 date "2018-09-01" @default.
- W2891290553 modified "2023-10-17" @default.
- W2891290553 title "Epididymal sperm retrieval by modified open fine needle aspiration" @default.
- W2891290553 doi "https://doi.org/10.1016/j.fertnstert.2018.07.844" @default.
- W2891290553 hasPublicationYear "2018" @default.
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