Male infertility is a serious problem of our time, therefore timely diagnosis and identification of the true causes of the disease is important.
A fairly informative and practically error-free diagnostic procedure is testicular biopsy - a procedure that helps to determine the causes of infertility and many other male pathologies.
A biopsy study involves obtaining a small piece of testicular tissue( testicle) for its histological examination.
Egg biopsy is a minimally invasive and effective diagnostic method, often used in the treatment of male infertility and in artificial insemination. The procedure helps to establish for sure whether sperm cells are produced in the testicles or not.
Indications
Male testicles are the most important for childbirth, but a very vulnerable organ. If there are no live spermatozoa in the ejaculate, then without treatment, a man can not become a father.
Eggs are laid in the womb, so their condition is greatly influenced by factors affecting the body of the pregnant mother.
In the future, the health of the testicles depends on the lifestyle of the man and the infections he has suffered.
Therefore, if you have problems with conception, you need to find out the causes of male infertility, in order to eliminate them if possible.
Biopsy research has several objectives:
- Detection of azoospermia, when a man does not produce sperm;
- Definition of the nature of education;
- Obtaining a seed for its use in artificial insemination;
- With hypogonadism( testicular failure) and cryptorchidism( non-admission to the scrotum of the testicle).
Contraindications
Obtaining a biopsy specimen from the testicles can be done far from every man, because the procedure has a number of contraindications:
- The presence of a man only one testicle;
- Diathesis of hemorrhagic type;
- Presence of infectious processes transmitted through sexual intercourse;
- The presence of inflammatory processes in the body;
- Blood flow problems.
Methods of conducting
In practice, several methods for obtaining a biopsy from the testicles are most often used:
- Vacuum transdermal biopsy with sperm collection from the testicle - TESA, a puncture method, when a testicular puncture is performed through the scrotal skin and aspirate the contents;
- Vacuum percutaneous preparation of spermatozoa from the ovarian appendage - PESA, a puncture technique involving the extraction of a biopsy by inserting a needle into the appendage;
- Extraction of spermatozoa from the testicle itself - TESE, open surgery, involving excision of wedge-shaped testicular tissues;
- Microsurgical method for obtaining spermatozoa from the epididymis - MESA, an open microsurgical procedure involving the isolation of a large adnexal tubule and the subsequent aspiration of its contents;
- Microsurgical extraction of the sex cell structures from the testicle is m-TESE, an open operation in which the doctor opens the scrotum, reveals the testicle, then secures the best tubules under the microscope, where the sperm count is higher.
Preparation for analysis of
Preliminary preparation for biopsy of testicles assumes adherence to the principle of accumulation of seed material, the stage begins approximately 5 days before the procedure.
These days, a man should always abstain from sexual abstinence, do not drink alcohol, do not smoke, refuse bathing procedures and visit the sauna.
Compliance with these conditions is mandatory, otherwise the doctor may incorrectly interpret the results, make an erroneous conclusion about the possibility of conceiving your own child, and advise you to use donor cells for conception.
On the eve of the biopsy, before taking a biopsy, you must give up food( after 20:00).
In the morning during the shower you need to shave off all the vegetation in the groin and on the scrotum. Why shave the scrotum on the day of the procedure? Just an earlier shave can cause irritation, and by the time of the biopsy in the groin will pustules.
Preliminary delivery of
tests Before the procedure, the patient must necessarily undergo laboratory tests such as:
- PCR for the presence of causative agents of infections of the genital area, for example, ureaplasmas, Trichomonas, chlamydia, etc.; Smear from the urethra for flora research;
- Blood test total;
- Analyzes for syphilis, hepatitis, HIV.
In addition, the patient must pass a coagulogram, blood for the Rh, electrocardiogram. The latter is necessary to determine the state of the heart, so that the anesthesiologist can choose the optimal dosage of anesthetic.
Technique for conducting
In general, all methods for obtaining bio-samples from testicles are divided into surgical( open) and puncture. The first suggest surgical intervention, the latter carried out with the help of needles.
Open
Open testicular biopsy is a microsurgical operation. This includes methods TESE, MESA, m-TESE.
Skin on the scrotum and testicles are dissected by a small incision( ≈3 cm).Then make a small section of the egg white shell. As a result, a small aperture is formed, into which the testicular tissue is protruded because of the internal pressure. It is cut off for histology, then stop the blood, sew all the incisions.
Open diagnostic interventions are performed exclusively in the operating room. The most difficult is micro-TESE, but this procedure is the most effective in terms of obtaining spermatozoon material.
Puncture
The procedure for puncture biopsy of the testis involves obtaining a bio-sample transdermally with a needle. This includes methods PESA, TESA.
The procedure is performed under local anesthesia. Under ultrasound guidance, the urologist enters the aspiration needle through the scrotum, through which the sperm is collected.
The whole procedure takes about a quarter of an hour.
The resulting spermatozoon biomaterial is used for histological examination, ICSI or IVF, or frozen for future use.
This video shows the basic stages of performing the puncture method of testicular biopsy:
Decoding of the results of
In order for the results of the procedure to be of high reliability, it is necessary to strictly follow the medical instructions and observe the rules of preparation for the procedure. It is not necessary to engage in independent interpretation of the results, it is only the doctor who can do it.
Probable complications of
If a biopsy sampling is performed blindly, the probability of damage to the vessels increases, which in the testicles is quite a lot. As a result, hemorrhage occurs, and hematoma forms.
And any hemorrhage is a favorable environment for reproduction and growth of pathogenic microorganisms. Therefore, when a large hematoma is formed after a biopsy test of the testicle, it is recommended that all medical recommendations be followed, that all procedures prescribed by the specialist be carried out.
Eggs have a very rich blood supply, so if there is no hematoma, infectious processes do not develop. If, in the course of manipulating the suture, the vessels are damaged, then the risk of developing testicular atrophy is increased.
Among the most common complications experts call morbidity and swelling in the field of taking bio-samples.
These disorders do not require separate therapy, they pass independently after a few days.
Very rarely there is an inflammatory complication in testicles or their appendages, orchitis or epididymitis develops. Then the patient is prescribed a course of antibiotic therapy. For the removal of symptoms it is recommended to apply lotions and compresses.
Wound care in the postoperative period
With the immobilizing purpose, a man is shown wearing a suspensions for several days. Linen must be worn cotton, preferably in the form of swimming trunks, which will not rub, cause uncomfortable sensations, provoke sweating in the groin.
Genitalia should be washed daily with soap and water, panties should be changed daily, but the wash should be done so that the area of the wound does not get wet.
Over time, the treatment is carried out once a day until the complete healing of the wound occurs. In the first three days after the biopsy, you can not take a bath and go to the shower.
Reviews of men about a testicle biopsy
Igor:
For the last year and a half, I've been running around doctors. We planned a child, but nothing happened. Have appointed a biopsy. The procedure refers to low-traumatic methods. The doctor leads the needle and tightens the tissue sample into it. As a result, ICSI was done. Recently, a daughter was born, so in my case, a biopsy became a real salvation.
Victor:
I'm wary of doctors, especially for urologists, but it turned out that I had to face the need for a biopsy from the testicles. The procedure is unpleasant, but necessary. It was not painful, but the doctor correctly diagnosed the diagnosis with a biopsy.
Cost of testicular biopsy
The average price for similar procedures is about 3500-28000 rubles. The total amount is made up of a set of rendered services, anesthesia, etc.
Video about testicular biopsy: