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The organs of the scrotum are the testicles, their appendages and the spermatic cords. The process of sperm formation occurs in the testicles, but their further maturation takes place in the appendages. Already matured, they are excreted along the cords. It is worth noting that it is in the testicles that testosterone is formed, which is necessary to perform important functions in the male body. In the organs of the scrotum, non-inflammatory, inflammatory diseases and diseases of a traumatic nature can develop – for example, testicular abscess.
Frequent diseases of the scrotum
Among the most common diseases of the scrotum, it is worth noting: inguinal mycosis, erysipelas, contact dermatitis, gangrene, abscess, genital warts, atheroma, injuries of the scrotum, tumor formations, funiculitis, spermatocele, deferentitis, varicocele, hydrocele, cryptorchidism, orchiepididymitis, epididymitis, orchitis .
The following diagnostic methods are used: MRI, puncture (biopsy of the scrotum), ultrasound of the scrotum, diaphanoscopy, laboratory tests, palpation and examination. In the article, we will examine in detail such a diagnostic method as puncture of the scrotum, and under what indications it is prescribed.
Puncture of the scrotum for infertility
Testicular puncture is a unique procedure that solves the problem of men with azoospermia, and is also used to temporarily eliminate testicular dropsy. Sperm for analysis can be obtained through a puncture (biopsy) or through a small incision in the scrotum. Each type of procedure has its own name: the puncture is called TESA, the biopsy through an incision is called TESE, and the adnexal puncture is called PESA.
Spermogram is a special procedure during which the ejaculate is examined. The results can be interpreted as follows: aspermia (no sperm or ejaculate); azoospermia (ejaculate without sperm); teratozoospermia (spermatozoa obtained during the procedure differ from the norm in morphological structure); asthenozoospermia (spermatozoa inactive); oligozoospermia (small amount of sperm); noospermia (the normal state of sperm that is suitable for conception).
How to prepare for the procedure
Testicular puncture is a therapeutic and diagnostic procedure in the case of a couple’s infertility treatment. It is worth noting that this procedure will also help to take spermatozoa for further IVF procedure.
Before the procedure, the patient is assigned a number of laboratory and clinical examinations, including: ECG, coagulogram, tests for syphilis, hepatitis and HIV, determination of the Rh factor and blood group, a smear from the urethra to determine the state of the flora and specific infections.
Before the procedure, it is forbidden to eat food for 12 hours, you can only drink water. Diagnosis is carried out on an empty stomach. It is important to carefully depilate the scrotum, lower abdomen and thighs so that there is no irritation of the skin.
Before the procedure, men must adhere to the following rules:
- within one month, men need to prevent an increase in body temperature of more than 38 degrees;
- 3 months before the procedure, refuse from saunas, baths and other thermal procedures;
- for 3 months to give up smoking, medicines, alcoholic beverages;
- 3 months to give up physical activity;
- 3 days before the procedure, refrain from sexual intercourse in order to accumulate the amount of sperm required for analysis.
Sperm collection algorithm
Local or general anesthesia (anesthesia) is required. All manipulations are carried out using a thin and very long biopsy needle.
After the anesthetic has taken effect, the needle is gently inserted through the skin of the scrotum directly into the testicle or its appendage, after which the spermatozoa are aspirated. If the aspirate is removed from the testicle, then the procedure is called TESA, and if from the appendages – PESA.
To date, two methods are distinguished after the materials necessary for analysis have been obtained: IVF using the ICSI method (the procedure is possible if an egg was taken from women); preservation of spermatozoa (obtained healthy and live spermatozoa are frozen before IVF, the maximum storage period is 1 year).
What men should be alerted after the procedure
During the puncture period, minimal surgical intervention is observed, but a number of complications may still appear: complications of an infectious type that require urgent and high-quality treatment; the formation of puffiness in the scrotum; pain in the puncture area on the scrotum; formation of hematomas and bleeding; inflammation of the testicle or its appendage.
Complications after a biopsy are extremely rare. If you follow the recommendations of the doctor, then all negative consequences are minimized. It is important to treat the wound area regularly, and refuse tight and tight underwear for at least a month.
Puncture of a hydrocele (dropsy of the ovary)
A puncture is indicated for carrying out if the patient has a number of the following problems: a pronounced increase in the scrotum, which causes both aesthetic and domestic inconvenience; if the operation was performed earlier, and fluid still accumulates in the scrotum.
Hydrocele puncture is not performed if the patient has an acute inflammatory process in the organs of the genitourinary system; in the presence of ulcers, wounds, irritations on the skin of the scrotum; with suspicion of the development of purulent inflammation.
This procedure is usually carried out in conjunction with ultrasound diagnostics or diaphanoscopy, thus reducing the risk of damage to important vessels and ducts. First, a procedure of local anesthesia or introduction into drug sleep is performed. After the anesthesia has worked, a hydrocele is punctured using a long and thick needle with a silicone tube (the fluid is discharged into the tray by gravity).
When the liquid ceases to stand out, the needle is carefully removed, the wound is treated with an antiseptic and a special sticker (antibacterial patch) is applied. In order to prevent the liquid from accumulating again, the doctor recommends that the patient wear special tight underwear with compression inserts for a month.
There are no special preparatory moments before the procedure, unless general anesthesia is used. Drug sleep is carried out only on an empty stomach (do not eat 12 hours before the procedure), after all allergy tests and cardiograms.
It is important to contact a urologist or proctologist with all problems or complaints in a timely manner. All problems must be solved in time, so as not to provoke the appearance of serious consequences.