Percutaneous testicular biopsy
Percutaneous (needle) testicular biopsy is a minimally invasive medical procedure performed using a special biopsy needle (tru-cut) and a tissue sampling device. The method is used to obtain a small tissue sample from the testicle for histological diagnosis of tumors, disorders of spermatogenesis, or in the treatment of male infertility.
Components of the procedure
- Biopsy needle (tru-cut): an instrument that ensures precise collection of a tissue fragment.
- Ultrasound guidance: used to navigate the needle and select the sampling site.
- Testicular tissue: the biological material obtained during sampling, which is then sent for histopathological examination to assess the structure of seminiferous tubules, the presence of spermatogenesis, or pathological processes, depending on the indications.
Role of the study
- Diagnosis of infertility of unknown origin (assessment of spermatogenesis).
- Detection of tumor processes (benign or malignant).
- Retrieval of sperm for IVF/ICSI programs.
- Monitoring condition after oncotherapy.
- Morphological evaluation of seminiferous tubule structure.
Indications
- Azoospermia or severe oligospermia.
- Suspicion of a testicular tumor.
- Preparation for assisted reproductive procedures.
- Diagnosis of spermatogenesis disorders.
- Follow-up after radiation or chemotherapy.
Contraindications
- Blood clotting disorders (coagulopathies).
- Acute inflammatory diseases of the scrotum (orchitis, epididymitis).
- Purulent skin infections.
- Severe general condition or fever.
Procedure
- The procedure is performed under local anesthesia.
- Under ultrasound guidance, a biopsy needle is inserted through the scrotal skin to collect a small piece of tissue.
- The material is sent to the laboratory for histopathological or other types of analysis, depending on the indication.
- Duration is 15–30 minutes, hospitalization is not required. After the procedure, physical exertion should be avoided for 2–3 days.
Percutaneous (needle) testicular biopsy is a safe and informative procedure used for diagnosing male infertility and testicular tumors. It helps determine the presence of spermatogenesis and the nature of pathological changes with minimal trauma.
Sources:
https://pmc.ncbi.nlm.nih.gov/articles/PMC3746403/
https://www.healthline.com/health/testicular-biopsy#preparation
https://www.sciencedirect.com/science/article/pii/S0015028298005184
https://europepmc.org/article/med/29550954
https://medlineplus.gov/ency/article/003908.htm
Preparation:
- Refrain from eating for 2–3 hours before the procedure.
- Discontinue anticoagulants and antiplatelet agents (aspirin, warfarin, etc. ) 5–7 days before the procedure, in agreement with the treating physician.
- Perform thorough hygiene and shave the scrotum on the day of the procedure.
- After the procedure, wearing supportive underwear (suspensory) is recommended to reduce discomfort and prevent swelling.