Open Access

ARTICLE

Repetitive percutaneous epididymal sperm aspirations (PESA’s) resulted in asthenospermia and significant inflammation

Yachao Zhang¹, Kazim R. Chohan^2,3, Steve K. Landas^3,4, Jay E. Reeder⁴, J.C. Trussell⁴

1 Department of Surgery, SUNY Upstate Medical University, Syracuse, New York, USA
2 Department of Obstetrics and Gynecology, SUNY Upstate Medical University, Syracuse, New York, USA
3 Department of Pathology, SUNY Upstate Medical University, Syracuse, New York, USA
4 Department of Urology, SUNY Upstate Medical University, Syracuse, New York, USA
Address correspondence to Dr. J.C. Trussell, Department of Urology, SUNY Upstate Medical University, 750 East Adams Street, Syracuse, NY 13210 USA

Canadian Journal of Urology 2014, 21(5), 7475-7478.

Abstract

Introduction: In obstructive azoospermia, choosing a sperm retrieval method for intracytoplasmic sperm injection (ICSI) depends on the preference and expertise of both the urologist and the reproductive endocrinologist. Generally, a percutaneous epididymal sperm aspiration (PESA) is attempted first. Not uncommonly, multiple PESA's are necessary. This study utilizes a rat model to provide an understanding of sperm parameter and histological changes resulting from repetitive PESA procedures.
Materials and methods: A cohort of 30 male Wistar rats of reproductive age (68-73 days) was divided into three groups of 10 (G1-G3). All three groups underwent a left epididymal head PESA using a 253/8 gauge needle. The untouched right epididymis acted as the control. At 14 day intervals, G2 and G3 underwent a second and third PESA respectively. Fourteen days after the final PESA, both epididymides and a 1 cm segment of both vas deferentia were harvested for sperm and histological evaluations.
Results: The percentage of vas specimens with a sperm count ≥5×10⁴/cc was 100%, 22%, and 20% for the G1, G2, G3 PESA samples respectively. Moreover, the percentage of the vas specimens with sperm motility ≥10% was 90%, 22%, and 20%, respectively. Epididymal granulomas were not seen in the control side, but formed in 70%, 100%, and 80% of G1, G2, G3 PESA specimens, respectively.
Conclusions: In a rat model, PESA resulted in significant epididymal inflammation and a reduction in both sperm concentration and motility.

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