Testicular Biopsy

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Test Overview

A testicular biopsy is a test to remove a small sample of tissue from one or both testicles . The tissue is then looked at under a microscope to see if the man is able to father a child.

The testicles (testes) are oval-shaped glands that hang in the scrotum under the base of the penis. The testes produce sperm (which is needed for reproduction) and male hormones, such as testosterone .

Why It Is Done

A testicular biopsy may be done to help find the cause of male infertility. But this is rare. It may also be done if both of the following are true:

  • The man's semen does not have sperm.
  • Hormone test results are within the normal range.

This test is not usually used to find testicular cancer . If your doctor thinks you may have cancer, you will probably have an open surgical procedure called an orchiectomy.

A testicular biopsy may also be done to get sperm for in vitro fertilization for intracytoplasmic sperm injection (IVF-ICSI).

How To Prepare

Before 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 to tell your doctor about all the medicines you take, even over-the-counter ones.
  • Take any blood-thinning medicines, such as warfarin (Coumadin), heparin, enoxaparin (Lovenox), aspirin, ibuprofen, or other NSAIDs .

You will be asked to sign a consent form that says you understand the risks of the test and agree to have it done.

Talk to your doctor about any concerns you have regarding the need for the test. Ask about its risks, how it will be done, and 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 the biopsy is done under local anesthesia , you don't need to do anything else to prepare.

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, or your surgery may be canceled. If your doctor has told you to take your medicines on the day of surgery, please do so using only a sip of water. Before the test, an intravenous line (IV) is inserted in your arm. You will get a sedative medicine about an hour before the test.

How It Is Done

This test is done by a surgeon or a doctor who treats reproductive health problems in men ( urologist ). It can be done in the doctor's office, a day surgery clinic, or a hospital operating room.

You will lie on your back on an exam table. The skin over your testicle is cleaned with a sterile solution. The area around it is covered with sterile cloth. Your doctor will wear gloves. It is very important that you do not touch this area.

A local anesthetic will be injected into the skin of the scrotum to numb the area. Then a small cut is made through the skin. A tiny piece of testicular tissue is removed with small scissors. A single stitch is used to close the cut in the testicle. Another stitch is used to close the cut in the skin. (The stitches do not need to be removed. Your body will absorb them over time). The procedure is usually done on the other testicle as well. The scrotal area is then bandaged. You will be asked to wear an athletic supporter for several days after the test. This will help support the testes while the cuts 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 not have sexual activity for 1 to 2 weeks after the test. Avoid washing the area for several days.

How It Feels

You will feel a brief sting when the IV line is put in or when the local anesthetic is given. Other than that, you should feel no pain.

Your scrotum and testes may be sore for 3 to 4 days after the biopsy. You may have some bruising. You may also notice a small amount of bleeding through the bandage. This is normal. Talk to your doctor about how much bleeding to expect.

Risks

There is a small risk of bleeding that lasts for a long time or infection from this test. There is no risk of erection problems or infertility. If general anesthesia is used, there is a small risk of a problem from anesthesia.

After the biopsy

Call your doctor right away 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).
  • More bleeding than expected through the bandage.

Results

Results from a testicular biopsy are usually ready in 2 to 4 days.

A pathologist looks at the sample through a microscope. He or she will then look for anything abnormal with the sperm. Sometimes sperm development looks normal, but a semen analysis test shows reduced or absent sperm. In that case, the tube from the testes to the urethra may be blocked. This tube is called the vas deferens . A blockage can sometimes be repaired by surgery.

What Affects the Test

It is important to stay very still while the test 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 cancer is suspected. Instead, a testicular ultrasound is often done to help diagnose suspected testicular cancer. To learn more, see the topic Testicular Ultrasound . If the doctor thinks you might have cancer, an open surgical procedure (orchiectomy) is done to confirm the diagnosis.

References

Other Works Consulted

  • Goldstein M (2012). Surgical management of male infertility. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 1, pp. 648–987. Philadelphia: Saunders.
  • Walsh TJ, Smith JF (2013). Male infertility. In JW McAninch, TF Lue, eds., Smith and Tanagho's General Urology, 18th ed., pp. 687–719. New York: McGraw-Hill.

Credits

ByHealthwise Staff

Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine

Specialist Medical Reviewer Christopher G. Wood, MD, FACS - Urology, Oncology

Current as ofFebruary 17, 2015