Testicular biopsy

Alternative names
Biopsy - testicle

Definition
Testicular biopsy is a procedure to obtain a sample of tissue from the testicles for examination. The testicles are the male reproductive organs, which produce sperm and the hormone testosterone.

How the test is performed

The biopsy can be performed in many ways. The method used is determined by the reason for the biopsy and the patient’s and doctor’s desires.

Open biopsy may be done in the health care provider’s office, a surgical center, or at a hospital. The skin over the testicle is cleaned with an antiseptic (germ-killing) solution. The area around it will be covered with a sterile towel. A local anesthetic will be given to numb the area. A small incision is made through the skin, and a small piece of the testicle tissue is removed. A stitch is used to close the opening in the testicle, and another stitch closes the skin incision. If necessary, the procedure will be repeated for the other testicle.

Needle biopsy is usually done in the health care provider’s office. The area is cleaned and local anesthesia is used just as in the open biopsy. A sample of the testicle is obtained using a special needle that does not require an incision in the skin. The patient should only feel pressure or discomfort similar to a pin prick.

Depending on the reason for the test, a needle biopsy may not be possible or recommended by the physician.

How to prepare for the test
Adults:
As a general rule, you should not take aspirin or medications that contain aspirin for 1 week prior to the procedure. Ask your doctor before discontinuing any medications.

Children:
The preparation you can provide for this or any test or procedure depends on your child’s age, previous experiences, and level of trust. Testicle biopsy is seldom performed in children younger than 12. For specific information regarding how you can prepare your child, see adolescent test or procedure preparation (12 to 18 years).

How the test will feel

There will be a sting when the anesthetic is given.

Why the test is performed

The test is usually performed to determine the cause of male infertility when a semen analysis suggests that there is abnormal sperm and other tests have not determined the cause.

Testicle biopsy may also be performed when testicular self-examination has revealed a lump. When tests such as testicular ultrasound suggest that the lump may be benign, your health care provider may recommend a biopsy to determine whether the lump is cancerous or benign. If ultrasound or biopsy suggests the lump is cancerous, the entire testicle is usually removed.

Normal Values

Sperm development appears normal.

What abnormal results mean

Abnormal results may suggest that proper sperm or hormonal function is not possible. Biopsy may be able to determine the cause of the dysfunction.

When sperm development appears normal within the testicle but semen analysis shows no sperm or reduced sperm, there may be a blockage of the tube through which the sperm travel from the testes to the urethra. This blockage can sometimes be repaired with surgery.

Abnormal results also include testicular cancer or benign diseases of the testicle such as spermatocele or orchitis.

All abnormal results should be discussed with you and explained by your health care provider.

What the risks are

There is a slight risk of bleeding or infection. The area may be sore for the following 2 to 3 days. The scrotum may swell or become discolored. This should clear up within a few days of the procedure.

Special considerations

Your health care provider may suggest that you wear an athletic supporter for several days after the biopsy. You will probably be asked to refrain from sexual activity for 1 to 2 weeks.

Keep the area dry for several days after the procedure.

Continue to avoid using aspirin or medications that contain aspirin for 1 week after the procedure.

Johns Hopkins patient information

Last revised: December 7, 2012
by Sharon M. Smith, M.D.

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