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Postoperative pain, complications, and satisfaction rates in patients who undergo surgical sperm retrieval
Simon Wood1, Kevin Thomas, Vicky Sephton
1Reproductive Medicine Unit, Women's Hospital, Liverpool, England. simon_j.wood@virgin.net
Objective:
To determine patients' experiences with surgical sperm retrieval and its common complications.
Design:
A questionnaire based survey using visual analogue scales (VAS) and closed questions to analyze complication, pain, and satisfaction rates.
Setting:
Tertiary care university hospital.
Patient(S):
One hundred consecutive males undergoing surgical sperm retrieval by percutaneous epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE).
Intervention(S):
None.
Main Outcome Measure(S):
We surveyed for pain perception complication rates and satisfaction scores.
Result(S):
Of the 85 patients who replied, 21 underwent retrieval for nonobstructive causes, 37 following failed reversal of vasectomy, and 27 for other obstructive causes. Retrieval was successful in 100% of obstructive causes and in 61% for nonobstructive azoospermia. Epididymal retrieval was successful in 23 patients, 30 patients underwent TESE after failed PESA, and 23 had TESE only. There were significant increases in pain perception scores and reported complications with TESE over PESA (31 vs. 16; and 21 out of 63 vs. 2 out of 22, respectively), but no difference in satisfaction rate. The cause of azoospermia did not affect pain perception or satisfaction in TESE. Complication rates were increased in larger testes (3 out of 22 vs. 24 out of 63). Unsuccessful sperm retrieval did not significantly affect patients' pain perception or satisfaction. Surgical sperm retrieval was rated as significantly less painful than both vasectomy and reversal (21% vs. 42% vs. 57%, respectively) and was associated with significantly fewer days absent from work (3.0 vs. 8.5).
Conclusion(S):
Surgical sperm retrieval by PESA or TESE is a safe procedure with only minor complications that is tolerated well by patients.
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