Ebook Atlas of office based andrology procedures: Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Atlas of office based andrology procedures: Part 2
Ebook Atlas of office based andrology procedures: Part 2
Chapter 9Nonsurgical Sperm RetrievalJohn p. Mulhall and Lawrence c. JenkinsIntroductionNonsurgical sperm retrieval is a less-invasive process compared Ebook Atlas of office based andrology procedures: Part 2d to surgical sperm retrieval. Nonsurgical procedures include percutaneous testicular sperm aspiration or biopsy and percutaneous epididymal sperm aspiration. These techniques are a less-invasive and usually less-expensive alternative to the open surgical techniques. However, it is important that th Ebook Atlas of office based andrology procedures: Part 2e right patient is chosen, ideally a male with normal spermatogenesis (obstructive azoospermia). In addition, there is usually significantly lower numEbook Atlas of office based andrology procedures: Part 2
bers of sperm recovered using percutaneous methods compared to open.IndicationsThese procedures can be used when there is a reasonable spermatogenesisChapter 9Nonsurgical Sperm RetrievalJohn p. Mulhall and Lawrence c. JenkinsIntroductionNonsurgical sperm retrieval is a less-invasive process compared Ebook Atlas of office based andrology procedures: Part 2enital absence of bilateral vas deferens.J.p. Mulhall. MD. MSc. FECSM, FACS (El) • L.c. Jenkins, MD. MBADepartment of Surgery. Section of Urology. Memorial Sloan Kettering Cancer Center.16 East 60th Street. Suite 402. New York. NY 10022, USAe-mail: Mulhaljl@mskcc.org: JenkinLI@mskcc.org© Springer In Ebook Atlas of office based andrology procedures: Part 2ternational Publishing Switzerland 201763J.p. Mulhall. L.c. Jenkins (eds.). Atlas of Office Based Andmlogy Procedures,nm in IIYI7/Q7S A ĨIQ 17I7S n Q6Ebook Atlas of office based andrology procedures: Part 2
4J.p. Mulhall and L.c. JenkinsPre-procedural ConsiderationsSerum FSH level should be obtained to assess testicular function prior to deciding between Chapter 9Nonsurgical Sperm RetrievalJohn p. Mulhall and Lawrence c. JenkinsIntroductionNonsurgical sperm retrieval is a less-invasive process compared Ebook Atlas of office based andrology procedures: Part 2spermia likely when FSH less than 7.6 mIU/mL or testicular long axis greater than 4.6 cm). Having an embryologist available for real-time analysis of testicular tissue specimen is considered ideal bit often not possible.ProcedureIn the office setting, a medication like diazepam may be helpful to low Ebook Atlas of office based andrology procedures: Part 2er the patient's anxiety level. The entire procedure is performed under local anesthesia so good spermatic cord blocks should be performed. The skin oEbook Atlas of office based andrology procedures: Part 2
verlying the area of entry should also be anesthetized.Epididyinal Sperm Aspiration (Fig. 9.Ị)After anesthesia has been delivered, the testicle and epChapter 9Nonsurgical Sperm RetrievalJohn p. Mulhall and Lawrence c. JenkinsIntroductionNonsurgical sperm retrieval is a less-invasive process compared Ebook Atlas of office based andrology procedures: Part 2 the caput epididymis until fluid is seen in the tubing and enough is obtained for its intended purpose. The needle can be redirected to aspirate more fluid. Sample should be transferred to sperm transport media for examination by an embryologist. If good quality, adequate number of motile sperm are Ebook Atlas of office based andrology procedures: Part 2 found there is no need to repeat the procedure on the same side (caput or corpus) or move to the opposite side.Fig. 9.1 Epididymal sperm aspiration9Ebook Atlas of office based andrology procedures: Part 2
Nonsurgical sperm RetrievalFig. 9.2 Percutaneous testicular sperm aspiration65Percutaneous Testicular Sperm Aspiration (Fig. 9.2)The steps for Illis pChapter 9Nonsurgical Sperm RetrievalJohn p. Mulhall and Lawrence c. JenkinsIntroductionNonsurgical sperm retrieval is a less-invasive process compared Ebook Atlas of office based andrology procedures: Part 2ered, the testicle should be secured between the thumb and index lingers. A 21 gauge butterfly needle attached to a 10 111L syringe can be used to aspirate fluid from the testicle until fluid is seen in the tubing and enough is obtained for its intended purpose. The needle can be redirected to aspir Ebook Atlas of office based andrology procedures: Part 2ate more fluid. Sample should be transferred to sperm transport media for examination by an embryologist. If good quality, adequate number of sperm isEbook Atlas of office based andrology procedures: Part 2
found there is no need to repeat the procedure on the same side or move to the opposite side.Percutaneous Testicular Biopsy (Fig. 9.3)After anesthesiChapter 9Nonsurgical Sperm RetrievalJohn p. Mulhall and Lawrence c. JenkinsIntroductionNonsurgical sperm retrieval is a less-invasive process compared Ebook Atlas of office based andrology procedures: Part 2ture. A short spring-loaded biopsy needle can then be used to take 3-5 cores from the testis, making sure to examine the quality of each core. Be careful not to biopsy your linger! Sample should be transferred to sperm transport media for examination by an embryologist. If good quality, adequate num Ebook Atlas of office based andrology procedures: Part 2ber of sperm is found there is no need to repeat the procedure on the same side or move to the opposite side.66J.p. Mulhall and L.c. JenkinsFig. 9.3 PEbook Atlas of office based andrology procedures: Part 2
ercutaneous testicular biopsyPost-procedural Management1Scrotal support for 72 11Chapter 9Nonsurgical Sperm RetrievalJohn p. Mulhall and Lawrence c. JenkinsIntroductionNonsurgical sperm retrieval is a less-invasive process comparedChapter 9Nonsurgical Sperm RetrievalJohn p. Mulhall and Lawrence c. JenkinsIntroductionNonsurgical sperm retrieval is a less-invasive process comparedGọi ngay
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