MRI Guided Prostate Biopsies:Amazing Technology

The images below show a subtle lesion proven on biopsy to be high grade prostate cancer.  

Listen to me speak on the radio about prostate cancer

Mapping for sperm

Sperm production within the testis can be haphazard and sporadic.   The absence of sperm in one area does not mean that sperm will be absent in another area.   This fact has important implications for men with azoospermia who require sperm retrieval procedures. 

Where is the best place to look for sperm within a testicle?

Answer: depends and varies case by case.  

There are 2 strategies that urologists employ to maximize sperm retrieval rates in men with non obstructive azoospermia: the mTESE and the TFNA mapping.  Both have advantages and disadvantages.  I have adopted the mapping as my first step.   It allows me to determine if sperm is present and where in an efficient and minimally invasive way PRIOR to committing the man to an invasive sperm retrieval procedure and the woman to IVF.   When I find sperm on a mapping I can then proceed with confidence to the next step, the TESE.   If I don't find sperm on a mapping, then I recommend mTESE   

Good anatomic drawing

Finding prostate cancer is not always so easy

The image above underscores the importance of advanced imaging and biopsy techniques that enable urologists to locate prostate cancer.

The great ejaculatory merger

The vas deferens, which start at the tail of the epididymes, end at the ampulla, seen here.  They join the seminal vesicles, seen here in pink, and together enter the prostate, in yellow.   At this great merger, the sperm that are present in high concentration in the ampulla, pick up essential nutrients from both prostate and seminal vesicles.  The health of all e structures is critical to male fertility.  

Kidney stone treatment by location

A good view of the right vas deferens, testis, and epididymis

The Male Reproductive Tract Complete

The Male Reproductive Tract

The testis produce sperm. The sperm mature in the epididymes. The vasa deferentia are muscular structures that transmit them to the ejaculatory ducts (not shown). The seminal vesicles produce proteins important for sperm function. Dr Schoor