THE EFFICACY OF LOCAL-ANESTHESIA FOR PERCUTANEOUS EPIDIDYMAL SPERM ASPIRATION AND TESTICULAR SPERM ASPIRATION

A total of 37 percutaneous epididymal sperm aspiration (PESA) and/or t esticular sperm aspiration (TESA) procedures were performed under loca l anaesthesia (LA) on 34 men between June and November 1996. Local ana esthesia was achieved by injecting 10 mi of 1% lignocaine solution alo ng the sides of the vas deferens near the external inguinal ring (sper matic cord block). Sperm retrieval was successful in 92% of the proced ures. Of the 37 procedures, in 29 the patients felt either no pain or mild discomfort while in six they experienced moderate but tolerable p ain. Analgesia was incomplete in two procedures and was supplemented w ith i.v. sedation. Vasovagal reflex in two procedures was reversed by i.v. atropine. In 24 procedures patients felt relaxed, whilst in 13 th ey felt anxious. In 32 procedures the patients expressed overall satis faction. If the procedure was to be repeated, after 29 procedures the patients requested LA again, while after four procedures they preferre d i.v. sedation and after four were undecided. LA is adequate for PESA and TESA in a large proportion of patients. Prior discussion of LA te chnique with the patient is necessary. Back-up facilities for i.v. sed ation and atropine should be available.