Monday, September 29, 2008

TESE Technique for post blockage/vasectomy sperm retrieval

Some urologists asked me how I do a TESE. Here's a step by step:
  • perform a perivasal cord block
  • grasp the testicle so that the scrotal skin is held taught
  • infiltrate the skin and dartos with the local
  • make an incision through the skin and deepen it to expose the testicle within the tunica vaginalis (TV) sac
  • excise in to the TV to expose the testicle
  • place a 4-0 monocryl into the upper pole of the testis
  • incise into the tunica albuginea (TA) of the testicle with the beaver blade
  • remove some tubules and place them un media
  • Wet prep of some sort to look for sperm present or absent and motility
  • Hemostasis with bipolar as needed
  • close the TA with the monocryl
  • repeat above procedure as needed to find good quality sperm
  • replace testicle to usual anatomic location, if necessary
  • close TV and dartos with 3-0 chromic
  • close dartos and skin with 4-0 monocryl
  • dermabond and steris on skin

That's how the pros do it. Need one or know someone that does: