Azoospermia is found in 1-3% of general population and 10-15% of men presenting with infertility (1). In this scenario, there are no spermatozoa in the patient's semen after centrifugation, and pregnancy may be achieved through IVF/ Intracytoplasmic sperm injection (ICSI) (2, 3) combined with sperm retrieval techniques (e.g. PESA, testicular sperm extraction - TESE, MESA, TESA). These techniques are commonly conducted under local anaesthesia, which a 10-15 mL solution of 2% lidocaine hydrochloride injected around the spermatic cord near the external inguinal ring (4). However, needle fear is prevalent in both children (~33-63%) and adults (~14-38%) and can contribute to negative experiences with needle procedures and health care for patients, caregivers, and health professionals (5-7). In clinical practice, patients often concern about the pain, trauma and possible complication (i.e. wheal, hematoma, infection) of needle injection of local anaesthesia into and through the scrotal wall when performing sperm retrieval. It not only interferes with clinicians' abilities to carry out procedures (e.g. due to flailing and attempts to escape), but also undermines the efficacy of pain interventions at the time of the needle (8). Therefore, receiving local anaesthesia without a needle is easily well accepted by the patients with azoospermia.