Test Overview
A testicular biopsy is a test to remove a small sample of tissue from one
or both
testicles and examine it under a microscope to
evaluate a man's ability to father a child.
The
testicles (testes) are oval-shaped glands that hang in
the scrotum beneath the base of the penis. The testicles produce
sperm (necessary for reproduction) and male hormones,
such as
testosterone.
Why It Is Done
A testicular
biopsy may, on rare occasions, be done to help
determine the cause of male infertility. Testicular biopsy may be done if both
of the following are present:
- The man's
semen does not have sperm.
- Hormone test results are within the normal
range.
Testicular biopsy is not usually used to detect
testicular cancer. When cancer is suspected, an open
surgical procedure (orchiectomy) is done to confirm the diagnosis.
Testicular biopsy may also be done to retrieve sperm for
in vitro fertilization for
intracytoplasmic sperm injection (IVF-ICSI).
How To Prepare
Before having a testicular biopsy, be
sure to tell your doctor if you:
- Have had any bleeding problems.
- Are allergic to any
medicines, including anesthetics.
- Take any medicines regularly. Be
sure your doctor knows the names and doses of all your
medicines.
- Are taking any blood-thinning medicines, such as
warfarin (Coumadin), heparin, enoxaparin (Lovenox), aspirin, ibuprofen, or
other
nonsteroidal anti-inflammatory drugs (NSAIDs).
You will need to sign a consent form that says you
understand the risks of a testicular biopsy and agree to have the biopsy. Talk
to your doctor about any concerns you have regarding the need for the test, its
risks, how it will be done, or what the results will mean. To help you
understand the importance of the biopsy, fill out the
medical test information form(What is a PDF document?).
If a testicular biopsy is done under
local anesthesia, no other special preparation is
needed.
If the
biopsy is done under
general anesthesia, your doctor will tell you how soon
before surgery to stop eating and drinking. Follow the instructions exactly
about when to stop eating and drinking, or your surgery may be canceled. If
your doctor has instructed you to take your medicines on the day of surgery,
please do so using only a sip of water. During
preparation for the biopsy, an
intravenous line (IV) is inserted in your arm, and a
sedative medicine is given about an hour before the
biopsy.
How It Is Done
This biopsy is done by a
surgeon or a doctor who treats reproductive health
problems in men (urologist) in the doctor's office, a day surgery
clinic, or a hospital operating room.
You will lie on your back on
an examining table. The skin over your testicle is cleaned with an antiseptic
solution, and the area around it is covered with sterile cloth. Your doctor
will wear sterile gloves. It is very important that you do not touch this
sterile area.
A local anesthetic will be injected into the skin of
the scrotum to numb (anesthetize) the area. Then a small incision is made
through the skin, and a tiny piece of testicular tissue is removed with small
scissors. A single stitch is used to close the incision in the testicle, and
another stitch is used to close the incision in the skin. (Absorbable sutures
are used so the stitches do not need to be removed.) The procedure is usually
repeated on the other testicle. The scrotal area is then bandaged. You will be
asked to wear an athletic supporter for several days after the procedure to
help support the testicles while the incisions heal.
If general
anesthesia is used, you will be asleep during the procedure but the same method
will be used.
The biopsy usually takes 15 to 20 minutes. You will
probably be advised to refrain from sexual activity for 1 to 2 weeks after the
biopsy. You should avoid washing the area for several days.
How It Feels
You will feel a brief sting when the IV
line is inserted or when the local anesthetic is injected. Other than that, the
procedure should be painless.
Your scrotum and testicles may be
somewhat sore for 3 to 4 days after the biopsy and some bruising may be
present. You may also notice a small amount of bleeding through the bandage,
which is normal. Talk to your doctor about how much bleeding to expect.
Risks
There is a slight risk of prolonged bleeding or
infection from this procedure. There is no risk of erection problems or
infertility as a result of this biopsy. If general anesthesia is used, there is
a small risk of complications from anesthesia.
After the biopsy
Call your doctor immediately if
you have:
- Severe pain in your scrotum. Some mild discomfort is
normal.
- Severe swelling of your scrotum. Some mild swelling is
normal.
- A fever higher than
100°F (38°C).
-
Excessive bleeding through the bandage.
Results
A testicular
biopsy is a test in which a small sample of tissue is
taken from one or both
testicles and examined under a microscope to evaluate
a man's ability to father a child. Results are usually available in 2 to 4
days.
A
pathologist examines the biopsy sample through a
microscope for any abnormalities in sperm production or maturation. If sperm
development appears normal yet a semen analysis test shows reduced or absent
sperm, a blockage of the tube (vas deferens) from the testes to the
urethra is suspected. A blocked vas deferens can sometimes be repaired by
surgery.
What Affects the Test
It is important to remain
completely still while a biopsy is done under
local anesthesia. If this is not possible, general
anesthesia may be needed.
What To Think About
Testicular cancer is more likely to spread when a testicular biopsy is done. For
this reason, a biopsy usually is not done if testicular cancer is suspected. A
testicular
ultrasound is generally done to help diagnose
suspected testicular cancer. For more information, see the topic
Testicular Ultrasound. When cancer is suspected, an
open surgical procedure (orchiectomy) is done to confirm the diagnosis.
References
Other Works Consulted
- Lipshultz LI, et al. (2007). Surgical management of
male infertility. In AJ Wein et al., eds., Campbell-Walsh Urology, 9th ed., vol. 1, pp. 654–717. Philadelphia: Saunders
Elsevier.
- Turek PJ (2008). Male infertility. In EA Tanagho, JW
McAninch, eds., Smith's General Urology, 17th ed., pp.
684–716. New York: McGraw-Hill.
Credits
| By | Healthwise Staff |
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| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
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| Specialist Medical Reviewer | Christopher G. Wood, MD, FACS - Urology, Oncology |
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| Last Revised | January 31, 2011 |
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