The efficacy of local anaesthesia for percutaneous epididymal sperm aspiration and testicular sperm aspiration

A total of 37 percutaneous epididymal sperm aspiration (PESA) and/ortesticular sperm aspiration (TESA) procedures were performed under localanaesthesia (LA) on 34 men between June and November 1996. Localanaesthesia was achieved by injecting 10 ml of 1% lignocaine solution alongthe sides of the vas deferens near the external inguinal ring (spermaticcord block). Sperm retrieval was successful in 92% of the procedures. Ofthe 37 procedures, in 29 the patients felt either no pain or milddiscomfort while in six they experienced moderate but tolerable pain.Analgesia was incomplete in two procedures and was supplemented with i.v.sedation. Vasovagal reflex in two procedures was reversed by i.v. atropine.In 24 procedures patients felt relaxed, whilst in 13 they felt anxious. In32 procedures the patients expressed overall satisfaction. If the procedurewas to be repeated, after 29 procedures the patients requested LA again,while after four procedures they preferred i.v. sedation and after fourwere undecided. LA is adequate for PESA and TESA in a large proportion ofpatients. Prior discussion of LA technique with the patient is necessary.Back-up facilities for i.v. sedation and atropine should be available.