Epididymal distension as a predictor of the success of PESA procedures.

PURPOSE: To evaluate the value of epididymal distension in predicting the success of percutaneous epididymal sperm aspiration (PESA) procedure.

METHODS

Physical examination of epididymis to detect epididymal distension and PESA were performed in 49 obstructive azoospermic patients divided into two groups according to its causes (Group I: previous vasectomy, n = 27 and Group II: other causes, n = 22).

RESULTS

Epididymal distension was found in 42 cases (85.7%). PESA was successful in 42 out of the 49 patients, giving a sperm retrieval rate of 85.7%. The success rate of PESA in Groups I and II is 92.6 and 77.3%, respectively. The accuracy, sensitivity, specificity, and positive and negative predictive value of epididymal distension for the overall patients were 86.7, 90.5, 64.2, 93.8, and 52.9%, respectively. The success rate of PESA procedure in patients with epididymal distension was significantly higher than in patients without epididymal distension (p < 0.05).

CONCLUSIONS

The presence of epididymal distension in obstructive azoospermic men was predictive of PESA success.