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Testicular biopsy

Definition

Testicular biopsy is surgery to remove a piece of tissue from the testicles. The tissue is examined under a microscope.

Alternative Names

Biopsy - testicle

How the Test is Performed

The biopsy can be done in many ways. The type of biopsy you have depends on the reason for the test. Your health care provider will talk to you about your options.

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 a germ-killing (antiseptic) medicine. The area around it is covered with a sterile towel. A local anesthetic is given to numb the area.

A small surgical cut is made through the skin. A small piece of the testicle tissue is removed. The opening in the testicle is closed with a stich. Another stitch closes the cut in the skin. The procedure is repeated for the other testicle if necessary.

Needle biopsy is most often 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 taken using a special needle. The procedure does not require a cut in the skin.

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

How to Prepare for the Test

Your health care provider may tell you not to take aspirin or medications that contain aspirin for 1 week before the procedure. Always ask your provider before stopping any medicines.

How the Test will Feel

There will be a sting when the anesthetic is given. You should only feel pressure or discomfort similar to a pinprick during the biopsy.

Why the Test is Performed

The test is most often done to find the cause of male infertility. It is done when a semen analysis suggests that there is abnormal sperm and other tests have not found the cause. In some cases, sperm obtained from a testicular biopsy can be used to fertilize a woman's egg in the lab. This process is called in vitro fertilization.

Testicular biopsy may also be done if you have found a lump during testicular self-examination. If tests such as testicular ultrasound suggest that the lump may be in the testicle, surgery may be needed to look at the testicle more closely.

A biopsy to determine whether the lump is cancerous or noncancerous (benign) may be done. If cancer is found or suspected, the entire testicle is removed.

Normal Results

Sperm development appears normal.

What Abnormal Results Mean

Abnormal results may mean a problem with sperm or hormone function. Biopsy may be able to find the cause of the problem.

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

Other causes of abnormal results:

Your health care provider will explain and discuss all abnormal results with you.

Risks

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

Considerations

Your health care provider may suggest that you wear an athletic supporter for several days after the biopsy. In most cases, you will need to avoid sexual activity for 1 to 2 weeks.

Using a cold pack on and off for the first 24 hours may lessen the swelling and discomfort.

Keep the area dry for several days after the procedure.

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

References

Barthold JS. Abnormalities of the testes and scrotum and their surgical management. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 132.

Elder JS. Disorders and anomalies of the scrotal contents. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 539.

Sabanegh E, Agarwal A. Male infertility. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 31.

Stephenson AJ. Gilligan TD. Neoplasms of the testis. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 31.


Review Date: 1/21/2015
Reviewed By: Scott Miller, MD, urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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