title: Epididymal distension as a predictor of the success of PESA procedures.
abstract: OBJECTIVE
  To evaluate the value of epididymal distension in predicting the success of percutaneous epididymal sperm aspiration (PESA) procedure.
  
  
  METHODS
  Physical examination of epididymis to detect epididymal distension and PESA were performed in 49 obstructive azoospermic patients divided into two groups according to its causes (Group I: previous vasectomy, n = 27 and Group II: other causes, n = 22).
  
  
  RESULTS
  Epididymal distension was found in 42 cases (85.7%). PESA was successful in 42 out of the 49 patients, giving a sperm retrieval rate of 85.7%. The success rate of PESA in Groups I and II is 92.6 and 77.3%, respectively. The accuracy, sensitivity, specificity, and positive and negative predictive value of epididymal distension for the overall patients were 86.7, 90.5, 64.2, 93.8, and 52.9%, respectively. The success rate of PESA procedure in patients with epididymal distension was significantly higher than in patients without epididymal distension (p < 0.05).
  
  
  CONCLUSIONS
  The presence of epididymal distension in obstructive azoospermic men was predictive of PESA success.
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. sukcharoen@yahoo.com
authors.forename: Nares
authors.initials: N
authors.lastname: Sukcharoen
authors.forename: Tippawan
authors.initials: T
authors.lastname: Sithipravej
authors.forename: Sakchai
authors.initials: S
authors.lastname: Promviengchai
mesh_terms: D000328:Adult; D002469:Cell Separation; D004822:Epididymis / Q000033:anatomy & histology* / Q000601:surgery; D006801:Humans; D008297:Male; D009845:Oligospermia / Q000473:pathology; D020554:Sperm Injections, Intracytoplasmic; D013094:Spermatozoa / Q000166:cytology* / Q000502:physiology