Testicular biopsy is surgery to remove a piece of tissue from the testicles for examination under a microscope.
Biopsy - testicle
How the test is performed
The biopsy can be performed in many ways. The method used depends on the reason for the biopsy and the patient's and doctor's wishes.
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, and a small piece of the testicle tissue is removed. A stitch is used to close the opening in the testicle. Another stitch closes the cut in the skin. If necessary, the procedure is 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 taken using a special needle that does not require a cut in the skin.
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
As a general rule, you should not take aspirin or medications that contain aspirin for 1 week before the procedure. Ask your doctor before stopping any medications.
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 rarely done in children younger than 12. For specific information about how to 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.You should only feel pressure or discomfort similar to a pin prick during the biopsy.
Why the test is performed
The test is usually done to find the cause of male infertility 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, a process called in vitro fertilization.
Testicle 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, your health care provider may recommend exploring the testicle through a surgical cut made in the groin.
A biopsy to determine whether the lump is cancerous or noncancerous (benign) may be done. If it is cancerous or cancer is suspected, the entire testicle is removed.
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.
If the sperm development appears normal in 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.
Other causes of abnormal results:
A cyst-like lump filled with fluid and dead sperm cells (spermatocele)
Your health care provider should explain and discuss all abnormal results with you.
What the risks are
There is a slight risk of bleeding or infection. The area may be sore for 2 - 3 days after the biopsy. The scrotum may swell or become discolored. This should clear up within a few days of the procedure.
Your health care provider may suggest that you wear an athletic supporter for several days after the biopsy. You will probably be asked to avoid sexual activity for 1 - 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.
Sigman M, Jarow JP. Male infertility. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 19.
Richie JP, Steele GS. Neoplasms of the testis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 29.
Olumi AF, Richie JP. Urologic surgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 77.
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.