Sperm Collection by Testicular Sperm Extraction (TESE)

This information will help you prepare for your sperm collection by testicular sperm extraction (TESE) procedure at Memorial Sloan Kettering (MSK).

TESE is a procedure to collect sperm directly from your testes. It’s done if there are no sperm found in your semen. You may have this procedure because:

  • Your testes aren’t making enough sperm to find in your semen.
  • A blockage is preventing your sperm from passing out of your penis during ejaculation.

Samples of tissue will be taken from your testicles and sent to a sperm bank. If sperm is found in the tissue, it will be frozen and stored. Men may have this procedure done to freeze their sperm before cancer treatment or to try to have a biologic child after cancer treatment.

After your procedure, your tissue samples will be brought to the Sperm Bank of New York, where they will be analyzed. If they find sperm, the tissue will be brought to the New Jersey sperm bank for freezing and storage. The address of the sperm bank is:

The Sperm and Embryo Bank of New Jersey
187 Mill Lane
Mountainside, NJ 07092

908-654-8836

Some sperm banks may offer less expensive storage fees. Speak with your healthcare provider if you’re interested in having your sperm moved to a different sperm bank or if you have any other questions.

 

Before Your Procedure

Ask about your medications

You may need to stop taking some of your medications before your procedure. Talk with your doctor about which medications are safe for you to stop taking.

Arrange for someone to take you home

You must have someone 18 years or older take you home after your procedure. If you don’t have someone to do this, call one of the agencies below. They will send someone to go home with you. There’s usually a charge for this service, and you will need to provide transportation.

Agencies in New York                                         Agencies in New Jersey
Partners in Care: 888-735-8913                                         Caring People: 877-227-4649
Caring People: 877-227-4649                                          

 

Tell us if you’re sick

If you develop any illness (fever, cold, sore throat, or flu) before your procedure, call the doctor who scheduled it for you. After 5:00 pm, during the weekend, and on holidays, call 212-639-2000 and ask for the doctor on call for your doctor.

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The Day Before Your Procedure

Note the time of your appointment

A clerk from the Admitting Office will call you after 2:00 pm the day before your procedure. If you’re scheduled for your procedure on a Monday, you will be called on the Friday before.

The clerk will tell you what time you should arrive for your procedure. They will also tell you where to go. If you don’t receive a call by 7:00 pm, call 212-639-5014.

If you need to cancel your procedure for any reason, call the doctor who scheduled it for you.

Instructions for eating and drinking before your surgery

12 ounces of water

  • Do not eat anything after midnight the night before your surgery. This includes hard candy and gum.
  • Between midnight and up until 2 hours before your scheduled arrival time, you may drink a total of 12 ounces of water (see figure).
  • Starting 2 hours before your scheduled arrival time, do not eat or drink anything. This includes water.

Your doctor may give you more instructions for eating and drinking before your procedure.

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The Day of Your Procedure

Things to remember

  • Take your medications the morning of your procedure as instructed by your doctor. Take them with a few sips of water.
  • Don’t put on any lotions, creams, powders, deodorant, makeup, or cologne.
  • Remove any jewelry, including body piercings.
  • Leave all valuables, such as credit cards and jewelry, at home.
  • If you wear contact lenses, if possible, wear your glasses instead. If you don’t have glasses please bring a case for your contacts.

What to bring with you

  • A list of the medications you take at home, including patches and creams.
  • Medications for breathing problems (such as inhalers), medications for chest pain, or both.
  • A case for your glasses or contacts.
  • Your Health Care Proxy form, if you have completed one.

What to expect

Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. People with the same or similar names may be having procedures on the same day.

You will get general anesthesia (medication to make you sleepy) to put you to sleep during the procedure. Your doctor will make a very small incision (surgical cut) in your scrotum (the pouch of skin holding your testes). They will examine your testes using a tiny microscope and remove small pieces of tissue from your testes. Then, your doctor will close the incision with sutures (stitches).

You will have a bandage (mummy wrap) around your scrotum and a scrotal support to hold the dressing in place. The scrotal support is a special type of underwear. You will also be given extra gauze to put between your bandage and scrotal support to use as compression.

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After Your Procedure

In the recovery room

You will recover in the Post Anesthesia Care Unit (PACU). When you wake up, you will be discharged home or brought back to your hospital room, if you’re in the hospital for other reasons.

At home

You may have mild pain and tenderness in your scrotum for a few days. You will get a prescription for pain medication. Take it as directed by your doctor.

Pain medication may cause constipation. Both over-the-counter (medication you get without a prescription) and prescription medications are available to treat constipation. Start with 1 of the following over-the-counter medications first:

 
  • Docusate sodium (Colace®) 100 mg. Take _____ capsules _____ times a day. This is a stool softener that causes few side effects. Don’t take it with mineral oil.
  • Polyethylene glycol (MiraLAX®) 17 grams daily.
  • Senna (Senokot®) 2 tablets at bedtime. This is a stimulant laxative, which can cause cramping.

You may also have mild bruising (a “black and blue” appearance) on your scrotum. Your penis and scrotum may be swollen. This is normal and should go away over the next week.

How to care for your scrotum

  • Apply cold packs against your bandage (outside your bandage, but inside your scrotal support). Keep the cold packs on for 48 hours, except for when you sleep. Remove the cold packs before going to bed.
  • Keep your bandage in place around your penis and scrotum for 2 days after your procedure.
  • Stay off your feet as much as you can for 3 days after your procedure. You can take short walks and climb stairs, if you need to.
  • Apply extra gauze inside your scrotal support for 4 days after your procedure.
  • Use the scrotal support for 1 week after your procedure.
  • When sitting, raise your legs on a chair or pillow.
  • When sitting, raise your scrotum on a small pillow or rolled up towel.

Activity

  • You can shower 3 days after your procedure. Don’t soak in a pool, bath tub, or hot tub for 2 weeks after your procedure.
  • You can resume your normal activity 3 days after your procedure. If you develop new pain, or your pain gets worse, as you do more activities, limit your activity until your pain gets better.
  • Don’t drive while you’re taking pain medication. The pain medication can make you drowsy.
  • Don’t lift any objects heavier than 10 pounds (4.5 kilograms) for at least 2 weeks after your procedure.
  • You can resume sexual activity 1 week after your procedure.
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Call Your Doctor or Nurse if You Have:

  • A temperature of 101°F (38.3°C) or higher
  • Pain that doesn’t go away with pain medication
  • Chills
  • Swelling in your scrotum or penis that’s getting worse
  • Drainage or pus coming from your incision
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