TESE (Testicular Sperm Extraction)

Operative Sperm Removal from the Testicles

TESE is used in patients who have no sperm cells in their ejaculate (azoospermia).
It is a minimal operation to obtain sperm from the testicles where sperm is produced.
Azoospermia is an advanced male infertility problem. Sperm ducts
problems in sperm production due to obstruction (obstructive azoospermia) or without obstruction
(non-obstructive azoospermia).

The main causes of azoospermia (no sperm in semen) are
Blockage in the sperm ducts
Undescended testicle
Hormonal problems
Congenital absence of sperm ducts
Genetic causes
Some medicines
Some infections
Radiation exposure
There are also cases of azoospermia of unknown cause.
In these azoospermia patients, after a detailed infertility evaluation, sperm
the appropriate technique for obtaining the sperm. A surgical operation from the epididymis
MESA, a method of sperm retrieval from the epididymis with a needle, PESA, a method of sperm retrieval from the testis with a needle.
TESA, which is a method of sperm retrieval, or TESE, which is a method of sperm retrieval by biopsy from the testicle
sperm can be obtained with the operation. Today, however, the most modern and
The successful one is the TESE operation.

TESE is a procedure performed under general or local anesthesia and takes about 2 hours. Testicle
It is visualized with a microscopic operation by making 1-2 cm incisions. This visible sperm
sperm cells are selectively removed from the ducts.

WHO IS SUITABLE FOR TESE OPERATION?
All patients with azoospermia (patients with no sperm in semen) are eligible for TESE.
is a candidate. Patients undergo genetic examination before the operation. Sex determinant in men
Y chromosomes are examined. On the Y chromosome is the chromosome responsible for sperm production.
Problems in the AZF region are detected. Patients with dysfunctional AZF area will benefit from TESE
will not be seen. However, unless there is a major problem in the AZF area, azoospermic
TESE can be easily applied to patients.

IS TESE A RISKY OPERATION, DOES IT DAMAGE THE TESTICLE?
Since TESE involves making incisions in the genital area, even if they are very small, slight bleeding or
there may be pain. Painkillers can be used. Since the procedure is in the genital area, hormonal
may have an effect on regularity, but this effect is short-lived, and the TESE procedure has no health or sexual
no permanent damage to function has been observed.

CAN TESE OPERATION BE REPEATED?
If the number and quality of the sperm taken with the TESE operation is sufficient for the procedure, a second
The sperm taken from the operation site can be frozen and used again when necessary.
However, when the frozen tissue is thawed, good quality sperm may not always be obtained. This
in which case a second TESE operation may be necessary. Likewise, with the first TESE operation
If the number and quality of the sperm collected is found to be insufficient, a second TESE operation may be performed.
In summary, this operation can be repeated until a high quality and sufficient number of sperm is obtained. TESE
If the operation is to be repeated, it would be correct to have 6 months between the two procedures.

WHAT IS THE SUCCESS RATE OF TESE OPERATION?
Although the success rate of the TESE procedure varies from person to person, it is estimated that 40 percent of patients with azoospermia
In 60% of cases, good quality and sufficient number of sperm can be obtained.

WHAT SHOULD I PAY ATTENTION TO BEFORE TESE OPERATION?
Blood pressure and blood sugar levels of people with chronic diseases such as hypertension and diabetes
It should be checked before TESE operation. If medications such as blood thinners are used, TESE
These medications should be discontinued one week before the operation under the supervision of a doctor.

THINGS TO CONSIDER AFTER TESE OPERATION
WHAT ARE THESE?
No hospitalization is required after TESE operation, 2-3 hours under observation
They can be discharged after being kept.
Heavy physical activities should be avoided for 10 days after TESE operation.
Those who have micro TESE surgery should not take a shower immediately.

It is not recommended to have sexual intercourse for 10 days after TESE operation.
Dressing should be done 48 hours after TESE operation. Sutures used in TESE
Since it dissolves spontaneously in about 1 week, there is no need to remove the stitches.
Patients are advised to wear tight underwear for 10-15 days after TESE.