Male Reproductive Surgery for Infertility
Male Reproductive Surgery in La Mesa, CA
Surgical diagnosis and treatment options for male infertility, including sperm extraction, sperm aspiration, vasectomy reversal, varicocele repair, electroejaculation, and epididymal repair.
Male reproductive surgery is performed to diagnose and treat issues of male infertility. While some types of male infertility, particularly those linked to sexual dysfunction, can be addressed by administration of hormones or behavior modification techniques, others must be addressed through surgical procedures offered at our office in La Mesa.
Male reproductive surgery near San Diego.
Alvarado La Mesa Urology provides surgical evaluation and treatment options for male infertility in La Mesa and surrounding San Diego communities.
Types of Male Reproductive Surgery
Surgical procedures to increase the chances of conception take several forms. A common type of male reproductive surgery involves the extraction of sperm. This can take place through a few different methods.
Testicular sperm extraction (TSE), also known as testicular biopsy, is a common in-office procedure performed to harvest tissue for in vitro fertilization (IVF) or for sperm donation. During this procedure a small amount of tissue is removed from the testicle while the patient is under local anesthesia. TSE is also performed to diagnose a low sperm count or azoospermia, a condition in which the man has no sperm in his semen. During TSE, several areas in the testis may be sampled since it is likely that there is a higher sperm count in some regions than in others.
Testicular sperm aspiration (TESA) is a similar procedure, differing from TSE only in that a needle biopsy of the testicle is taken. The aspirated sperm may be used for IVF or for intracytoplasmic sperm injection (ICSI), a procedure in which a single sperm is injected directly into an egg.
In percutaneous sperm aspiration (PESA), a needle is inserted into the epididymis in order to locate and aspirate a pocket of sperm. This technique is used on men who produce normal sperm, but for whom the sperm is not contained in the ejaculate because of an obstruction. The obstruction may be a result of a congenital defect, a previous vasectomy, or a blockage of the ejaculatory duct.
Reconstructive and Corrective Procedures
Other types of male reproductive surgery are performed to correct anatomical or medical conditions that may be preventing sperm from passing into the ejaculate.
A vasovasostomy is an operation to reverse a vasectomy. It is performed using microsurgical techniques to reconnect the vas deferens so that sperm can once again pass through during ejaculation. Although this procedure may re-establish male fertility, it is not always effective. For this reason, a vasectomy should be considered permanent. You can learn more about the vasectomy reversal procedure here.
In some men, infertility is caused by an enlarged varicocele (varicose vein) in the scrotum. The varicocele repair is achieved by making a small incision in the abdomen, and cutting the vein that feeds the varicocele. Alternatively, a varicocele may be repaired by percutaneous embolization, in which a catheter is inserted through a large vein in the groin or neck, and moved through the varicocele. The catheter contains a tiny coil that is inserted into the varicocele, blocking blood flow.
In men who have certain medical conditions, such as multiple sclerosis or diabetes, or in men who have suffered traumatic spinal injury, there may be abnormalities in the seminal emission or it may be absent altogether. Electroejaculation has been found to be an effective method of obtaining active sperm for various assisted reproductive techniques, enabling even men who cannot ejaculate normally to conceive young. The procedure takes place through the rectum under general anesthesia.
Epididymal repair is performed to bypass blockages or inflammation (epididymitis) in the epididymis, the tube which carries sperm from the scrotum to the vas deferens. During epididymal repair, viable portions of the epididymis are cut and reconnected using microsurgical techniques. This procedure enables sperm to pass normally during ejaculation.
Risks of Reproductive Surgery
In most cases, male reproductive surgery can be performed laparoscopically to reduce recovery time and risk of complications. The most common risk of such surgery is that it won't be effective in treating infertility.
Surgical approach, recovery time, risks, and success rates vary depending on the diagnosis, procedure type, sperm parameters, prior surgeries, partner factors, and whether assisted reproductive technology such as IVF or ICSI is part of the plan.
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Common questions about male reproductive surgery.
These answers are general educational information and are not a substitute for a medical evaluation. A urologist can help determine which surgical or non-surgical options may be appropriate.
What is male reproductive surgery for infertility?
Male reproductive surgery is performed to diagnose and treat issues of male infertility. Some infertility issues may be addressed with hormones or behavior modification, while others require surgical procedures.
What types of sperm retrieval surgery are available?
Sperm retrieval may include testicular sperm extraction, testicular sperm aspiration, or percutaneous sperm aspiration. Retrieved sperm may be used for IVF, ICSI, or other assisted reproductive techniques.
What is testicular sperm extraction?
Testicular sperm extraction, also known as testicular biopsy, is a procedure in which a small amount of tissue is removed from the testicle. It may be used to harvest sperm for IVF or to diagnose low sperm count or azoospermia.
What is PESA?
Percutaneous sperm aspiration, or PESA, involves inserting a needle into the epididymis to locate and aspirate a pocket of sperm. It may be used when sperm is produced normally but blocked from the ejaculate.
Can male reproductive surgery reverse a vasectomy?
A vasovasostomy is a vasectomy reversal procedure that uses microsurgical techniques to reconnect the vas deferens so sperm can pass through during ejaculation. Although it may re-establish fertility, it is not always effective.
Can varicocele repair help infertility?
In some men, infertility is caused by an enlarged varicocele in the scrotum. Varicocele repair or percutaneous embolization may be used to address the varicocele when appropriate.
What is the main risk of reproductive surgery?
The most common risk is that surgery may not be effective in treating infertility. Procedure-specific risks, recovery, and expected outcomes should be discussed during consultation.
Where can I get male reproductive surgery near San Diego?
Alvarado La Mesa Urology provides male reproductive surgery consultation and treatment in La Mesa, CA, serving patients from San Diego, El Cajon, Spring Valley, Lemon Grove, and nearby communities.
Credible educational references.
The educational information on this page is supported by reputable medical organizations and patient education resources. Always consult a qualified healthcare professional for diagnosis and treatment recommendations.
Schedule a male reproductive surgery consultation in La Mesa.
If male infertility may be related to sperm retrieval needs, obstruction, vasectomy, varicocele, ejaculation concerns, or reproductive tract anatomy, Alvarado La Mesa Urology can evaluate your options.