What is Testis Biopsy?
In order to evaluate a man’s ability to have a child, a testicular biopsy is done. This test is done by removing a small sample of tissue from one or both testicles and then studied under a microscope.
Effects of Testis Biopsy
On rare occasions, a testicular biopsy is done in order to help determine the cause of male infertility. This procedure may be performed if both of the following are present:
- Abnormal sperm count
- The results of the hormone test are within the normal range
This procedure is not generally used to identify testicular cancer. An orchiectomy which is an open surgical procedure is the procedure of choice in order to confirm the diagnosis.
Before undergoing this procedure, it is important to let your doctor know if you have any of the following conditions:
- Allergies to any medications as well as anesthetics
- Taking medications on a regular basis. Be sure that names and doses are made known to the doctor
- Taking in of any blood-thinning medications such as warfarin (Coumadin), heparin, enoxaparin (Lovenox), aspirin, ibuprofen or other nonsteroidal anti-inflammatory drugs (NSAIDs)
- Have had any problems with bleeding
A consent form will be signed by the patient stating that he understands the risk of undergoing a testicular biopsy and that he agrees to have the biopsy done. In order to give the patient a better understanding of the importance of the biopsy, make sure that you talk to your health care professional about any concerns or apprehensions that you may have regarding the need to undergo this procedure, any other options or alternative methods for the biopsy, the risks of undergoing a testicular biopsy, how will this be done, and what the results will indicate.
No other special preparation is needed if this procedure is done under local anesthesia.
On the other hand, if the procedure is done under general anesthesia, no eating or drinking is allowed approximately 8 to 12 hours prior to the biopsy. While the patient is being prepped for the biopsy, an intravenous (IV) line will then be inserted in the patient’s arm and a sedative will be given approximately an hour prior to the procedure.
The Testis Biopsy Procedure
This testis biopsy procedure will be administered by a urologist in the doctor’s office, a day surgery clinic, or in a hospital operating room.
The patient will be lying on his back on the examining table. Cleansing of the skin over the testicle will be done with the use of an antiseptic solution. The area surrounding it will then be covered with a sterile cloth. The doctor will be wearing sterile gloves as it is very important not to touch this sterile area.
To numb or anesthetize the area, a local anesthetic will be injected into the skin of the scrotum. A small incision is then created through the skin and removal of a tiny piece of testicular tissue is done with the use of small scissors. The incision in the testicle is then closed with a single stitch and another one is used to close the incision in the skin. The sutures are absorbable so that the stitches do not have to be removed. The same procedure is most of the time repeated on the other testicle. Finally, bandaging of the scrotal area is done. The patient will be encouraged to wear an athletic supporter for several days postoperatively in order to help support the testicles while the incisions are healing.
The same method will be used if a general anesthetic used except that during the surgery, the patient will be asleep.
It usually takes about 15 to 20 minutes for the biopsy to complete. Sexual activity should be avoided for about 1 to 2 weeks after undergoing the testicular biopsy. The testicular area should not be washed for several days.
One can expect the appearance of a small amount of bright red blood in the area biopsied. If the patient feels that the amount of bleeding is excessive, one should not be alarmed but should immediately inform his doctor. Prescription medications for pain and sometimes antibiotics are given at the time of discharge for an ambulatory surgical center. One should be careful when walking or climbing stairs as taking in of these medications may cause dizziness. Driving is not allowed after undergoing the procedure. Arrangements should be made for someone to drive the patient home after the surgery. The patient may take a shower 48 hours postoperatively. Until then, dressings should be kept dry. It is normal to experience some swelling and bruising in the area. The patient may return to work two or three days after the surgery if his job engages only in desk work or light activity. It is common to experience slight discomfort for the first few days post surgery. One week after the operation, heavy work, strenuous activities, or sports are not allowed. The patient is encouraged to wear an athletic supporter or a jock strap for a week after the surgery. Resumption of normal activities may be done if the patient feels ready to do them. Absorbable sutures are used so the patient does not have to come back for removal of the stitches. If other problems, questions, or complications are experienced after the surgery, make sure that you inform your healthcare provider immediately. Results of the biopsy will be available one week after the procedure.
There is a slight chance of experiencing prolonged bleeding or infection from the biopsy. If the patient had the biopsy under general anesthesia, a slight risk of complications may be experienced. On the other hand, undergoing a testicular biopsy does not pose a risk of any erection or infertility problems.
What is a testicle?
The testicles or testes are glands that are oval in shape and hang in the scrotum underneath the base of the penis. The testicles are responsible for the production of sperm, which is necessary for reproduction, and male hormones such as testosterone.
What can be felt during the biopsy?
A slight quick sting can be felt when the intravenous (IV) line is inserted or during the injection of the local anesthetic. Besides all that, this procedure should be painless.
After the procedure, the scrotum and testicles may feel to some extent sore for three to four days. Some bruising may also be expected. A small amount of bleeding through the bandage may be noticed but one should not be alarmed as this is normal. Ask your doctor about how much bleeding is to be expected.