Infertility: Management: Difference between revisions
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*#*Done with a high-suction glass syringe and a 23-gauge needle or angiocath sheath | *#*Done with a high-suction glass syringe and a 23-gauge needle or angiocath sheath | ||
*#*'''Least invasive and least painful procedure but usually yields few tubules with poorly preserved architecture and often requires 10 to 20 passes to obtain an adequate yield''' | *#*'''Least invasive and least painful procedure but usually yields few tubules with poorly preserved architecture and often requires 10 to 20 passes to obtain an adequate yield''' | ||
* '''Adverse Events'''**'''Most common complication is hematoma''' | * '''Adverse Events''' | ||
**'''Most common complication is hematoma''' | |||
====Approach==== | ====Approach==== | ||
*'''<span style="color:#ff0000">If azoospermia''' | *'''<span style="color:#ff0000">If azoospermia''' | ||
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*'''<span style="color:#ff0000">Stimulation can be done with penile vibratory devices or electroejaculation''' | *'''<span style="color:#ff0000">Stimulation can be done with penile vibratory devices or electroejaculation''' | ||
**'''<span style="color:#ff0000">Approach depends on level of spinal cord | **'''<span style="color:#ff0000">Approach depends on level of spinal cord lesion[https://www.ncbi.nlm.nih.gov/pubmed/12406364 §]''' | ||
***'''<span style="color:#ff0000">If lesion above T10, ejaculatory reflex arc will be intact so can stimulate with penile vibratory devices''' | ***'''<span style="color:#ff0000">If lesion above T10, ejaculatory reflex arc will be intact so can stimulate with penile vibratory devices''' | ||
***'''<span style="color:#ff0000">If lesion T10 or below, consider electroejaculation''' | ***'''<span style="color:#ff0000">If lesion T10 or below, consider electroejaculation''' | ||
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**'''<span style="color:#ff0000">Ejaculatory stimulation for men with spinal cord injuries may result in autonomic dysreflexia''' | **'''<span style="color:#ff0000">Ejaculatory stimulation for men with spinal cord injuries may result in autonomic dysreflexia''' | ||
***'''<span style="color:#ff0000">Autonomic dysreflexia''' | ***'''<span style="color:#ff0000">Autonomic dysreflexia''' | ||
****'''See 2019 CUA NLUTD Guideline Notes''' | ****'''See [[CUA: Neurogenic Lower Urinary Tract Dysfunction (2019)|2019 CUA NLUTD Guideline Notes]]''' | ||
****'''An uninhibited sympathetic reflex accompanied by headache, diaphoresis, hypertension, bradycardia, and diaphoresis''' | ****'''An uninhibited sympathetic reflex accompanied by headache, diaphoresis, hypertension, bradycardia, and diaphoresis''' | ||
****'''More common with spinal cord injury at a level of T6 or above''' | ****'''More common with spinal cord injury at a level of T6 or above''' | ||