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:

  • Take a blood thinner, or if you have had 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.

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
Adam Husney, MD – Family Medicine
Specialist Medical Reviewer Christopher G. Wood, MD, FACS – Urology, Oncology

Current as ofMay 5, 2017