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PESA

If a patient has a diagnosis of obstruction or a blockage, or those who have had a vasectomy and do not wish to undergo vasectomy reversal, sperm can be retrieved directly from the epididymis, or sperm reservoir. In most cases this can be performed under local anaesthetic, where a local anaesthetic block is placed within the sperm cord and sperm is aspirated directly from the epididymis. This is called a percutaneous sperm aspiration or PESA. It is possible to get good quantities of sperm that may also be used for freezing.  In some cases where the epididymis is difficult to feel or at the time of the aspiration the sperm quality is poor, then an open biopsy may need to be performed, a TESE (Testicular sperm extraction).

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