One of the side effects of these procedures, surgical sperm retrieval procedures such as TESE and TESA is removal of testicular tissue. If you remove testicular tissue, you’re removing some of the cells that produce testosterone as well and testosterone is a very important male hormone. So, repeated TESA or TESE can result in deficiencies in testosterone and in these patients and that’s why it’s important to minimize these types of surgeries in men and maybe offer a more delicate procedure such as microTESE which are more more less damaging and less invasive and remove less testicular tissue.
Normally, after testicular biopsy which is an intervention to the testicles and sometimes to both of them, we may have a period of discomfort, a local bleeding and hematoma but all of them are considered mild side effects of the technique and most of them may reduce within one or two days. So, the only issue for these males is that they may experience difficulty in walking or while sitting but again, in two days, normally, everything is back to normal.
If it’s TESE, obviously you’re coming to get it done if it’s done under a local anaesthetic. It’s a little bit uncomfortable, there’s a risk of bleeding and it can form a clot called the hematoma afterwards. Sometimes the hematomas just need a bit of painkillers and rest and support to dissolve their own accord. Sometimes they might need to be evacuated in an operating theater under anesthetic but that would be rare. There’s also a risk of infection. TESE, there’s small procedures – the risk is small but it can exist. It needs to be born in mind but overall infection rates, the bleeding rates from the smaller procedures aren’t that high. From the more invasive procedures obviously, there is perhaps a slightly higher risk of bleeding and infection if significant amounts of testicular tissue are taken away or if the patient has a complication or if the patient has a low testosterone to start with there’s a chance that an operation like this, could make them need to have testosterone in the future to remain healthy but for most of these patients, either something that they would have needed already or would have been likely to have needed in the future if it hadn’t had any treatment.
Surgical sperm retrieval obviously involves some sort of an anesthetic, if it is a less invasive operation it could be done with a local anesthetic , but in some cases we have to give some sort of sedation or possibly short general anesthetic, so the risks related to anesthesia will be there. There will be the generic risk of any operation which will be bleeding during the procedure, infection during or after the procedure and pain after the procedure, these are the main possible side effects. Also because we perform surgery on the tissue it may sometimes lead to scarring and the testes have two functions: one is the production of sperm and the other is the production of the male hormone- testosterone. In the long run, especially if there is a complication with infection, the patient can have low testosterone levels in the long run which could lead to symptoms of testosterone deficiency. These are possible, and again this is another generic side effect of any operation especially if it is prolonged is blood clots, although it is a quick procedure and usually should not lead to that, but it is always a theoretical possibility. So pain, bleeding, infection, scarring, blood clots, anesthetic complications and a possibility of low testosterone and obviously another side effect is that you may not find sperm.
