Serial sonography and colour flow Doppler imaging following testicular andepididymal sperm extraction

Percutaneous epididymal sperm aspiration (PESA), percutaneous testicular sp erm aspiration (TESA) and testicular sperm extraction (TESE) are invasive p rocedures and their consequences on the testis have not been clearly define d. In order to relate the sonographic and colour Doppler flow changes to th e clinical data, 14 patients with non-obstructive and six with obstructive azoospermia were examined by the same roentgenologist immediately before, a t 5 days, 2 weeks, 2 and 6 months after the surgical procedure. Testicular volumes remained unchanged during the followup period in both the non-obstr uctive and obstructive groups, Of the non-obstructive group, focal testicul ar lesions were seen in 20 of the 26 testes (77%) 5 days after the procedur e and in 54% by 6 months, Ten were hypoechoic, of which six converted to ec hogenic foci, three remained hypoechoic and one disappeared at 6 months. Th e other 10 were echogenic lesions, three of which were no longer visible at 6 months and the remainder mere unchanged. In the obstructive azoospermic group, focal lesions were not found. Extratesticular abnormality consistent with haematoma was demonstrated in four nonobstructive cases, which disapp eared at the 6 month examination, and in none of the obstructive azoospermi c patients. Whether residual focal lesions in the testes have long-term eff ects remains to be evaluated. In the obstructive azoospermic group, the asp irations performed did not leave any sonographic abnormalities.