From Susie:-
My husband had the MESA procedure (sperm aspiration) a year after his vasectomy so we could try to have a child. He had no issues with his vasectomy. The MESSA procedure was a very different experience. The doctor said there was a great deal of scar tissue from the vasectomy and she had trouble getting the testicle back into him after searching for sperm on the right side. The left side was fine and she retrieved sperm as planned. When he came out of the surgery he complained of tremendous pain (9 on a scale of 10). My husband has a high threshold for pain, so I was greatly concerned. He was diagnosed with a hematoma within 2 days with a great deal of swelling in his abdomen, groin and down his right leg. She said we would need to wait to see if it stopped bleeding on it’s own and the blood would absorb back into the body. Once the hematoma was diagnosed, he began to bleed through the stitches. We called the doctor and she said this was normal for a hematoma.
So we assumed it was bleeding out and doing fine. After a week, the stitches busted and there was blood and pus coming through the wound. He went back in to the doctor and she said this was normal and tried to stitch it back up again. “The old college try but it probably won’t stay.” It didn’t and busted again within a few days. We continued to put gauge on it each morning and night waiting for it to heal. A couple weeks later it began to smell really awful and pus even more. We got the on call doctor (we were also out of town on vacation) and he put him on antibiotics and said to pour alcohol on it each night if he could stand it. He couldn’t feel the alcohol other than cold but we assumed that was ok since the on call doctor said based on his experience alcohol kills everything.
We did this for 3 weeks. On his next scheduled checkup on the 4th week, it was supposed to be the size of a pin according to the doctor. My husband told the doctor the purple scab had peeled off a few days before and skin was flaking off. Also the smell had not gone away. She cut away some of the dead tissue and said she wanted to get him under to look open it up and look at the inside. He was back in surgery 2 days later. After 20 mins I was called into the consultation room. She said she’d never seen anything like it, the testicle looked and smelled dead but putting the ultrasound on it there was still blood flowing to it. I asked what we should do? I was worried about staff infection and long term risk to his life. She suggested it wasn’t a concern and she was waiting for tests back to see if the tissue was alive. She in the meantime cut everything dead she could see through the inflammation and probably got most of the testicle but really couldn’t be sure what she cut out. So now we’re trying to heal an open wound, there’s no open wound hospital care they can find over a holiday weekend. The doctor has been nice enough to offer to meet us at the ER tomorrow (Sunday) to change the dressing herself. We’re just wondering what we did wrong, why did he have to lose a testicle and what could we have done different when all we did was go in for a Mesa procedure that has gone horribly wrong and resulted in losing (maybe, but maybe not) his testicle. Our main concern is how can we understand for our own piece of mind what happened and how we can prevent anyone else from going through this horrible nightmare that was supposed to be a simple procedure?
Regards,
This case represents the worst consequence of a MESA procedure. MESA is the acronym for Microsurgical Epididymal Sperm Aspiration, a procedure used for retrieving sperm from an obstructed epididymis for the purposes of performing IVF/ICSI. It is considered a minimally invasive procedure with minimal side effects. Loss of a testicle is a devastating sequelae of this procedure and, fortunately, only occurs rarely. The reason why the severe infection developed can be a result of intra-operative contamination, lack of an adequate blood supply or due to co-morbid conditions of the patient. For example, diabetes mellitus can predispose patients to post-operative infections in situations where an infection would normally not have occurred. However, the decision to close the scrotum immediately after the first time the blood and pus came out was not the ideal decision. Once an infection has occurred, it is impossible to eradicate all of the bacteria and closing the wound only will trap the remaining bacteria in the scrotum, causing the infection to recur. Severe infections that are left untreated for several weeks can lead to the destruction of tissue.
Dr. Karpman’s website
Second semen sample was taken two months after surgery with motility at 42%
