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Testicular Fine Needle Aspiration Cytology versus Open Biopsy in the Evaluation of Azoospermic Men

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DOI: 10.4236/oju.2015.59021    2,549 Downloads   3,008 Views  

ABSTRACT

Background: Male infertility is a common problem and needs a minimally invasive method to arrive at the appropriate diagnosis. Alternative to open testicular biopsy the fine needle aspiration cytology (FNAC) of the testis is being increasingly used as a minimally invasive method of evaluating testicular function. Aim: To determine the causes of azoospermia and evaluate the efficacy of FNAC as compared to open testicular biopsy in evaluating azoosparmic men by correlating diagnosis from testis FNAC with biopsy histology. Patients and Methods: We prospectively studied 67 consecutive infertile patients who referred to andrology department of Al-Yarmouk Teaching hospital, Baghdad, Iraq between (January 2010-January 2014). All patients were azoospermic. They underwent bilateral testicular fine needle aspiration for cytological evaluation as well as bilateral testicular biopsy for histopathological correlation. Results: The morphological diagnosis revealed normal spermatogenesis in 12 patients (17.9%), hyposparmatogenesis in 4 (5.9%), spermatogenic arrest in 39 (58.2%), Sertoli cell only in 7 (10.4%), and complete tubular hyalinization in 5 patients (7.4%). Good correlation between the 2 methods was found in 120 (91.6%) testes which was identical in the right and left testis. Discrepancies between cytology and histology were mainly the result of insufficient and scanty smears. Conclusion: Testicular FNAC is a simple and minimally invasive alternative method to open testicular biopsy in the investigation and assessment of patients with azoospermia.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Al-Dabbagh, A. and Ahmed, B. (2015) Testicular Fine Needle Aspiration Cytology versus Open Biopsy in the Evaluation of Azoospermic Men. Open Journal of Urology, 5, 133-141. doi: 10.4236/oju.2015.59021.

References

[1] Babolhavaeji, H., Bahar, S.H.M., Anvari, N., et al. (2008) The Study of Detecting Sperm in Testis Biopsy in Men with Severe Oligospermia and Azoospermia by Two Methods of Wet Prep Cytologic and Classic Histopathologic. Indian Journal of Reproductive Medicine, 6, 101-104.
[2] Yildiz-Aktas, I.Z., Monaco, S.E., Khalbuss, W.E., et al. (2011) Testicular Touch Preparation Cytology in the Evaluation of Male Infertility. Cyto Journal, 8, 24.
[3] Geisinger, K.R., Raab, S.S., Stanley, M.W., et al. (2004) Modern Cytopathology. Churchill Livingstone, Philadelphia, 723-724.
[4] Craft, I., Tsirigotis, M., Courtauld, E., et al. (1997) Testicular Needle Aspiration as an Alternative to Biopsy for the Assessment of Spermatogenesis. Human Reproduction, 12, 1483-1487.
http://dx.doi.org/10.1093/humrep/12.7.1483
[5] Qublan, H.S., Al-Jader, K.M., Al-Kaisi, N.S., et al. (2002) Fine Needle Aspiration Cytology Compared with Open Biopsy Histology for the Diagnosis of Azoospermia. Journal of Obstetrics and Gynaecology, 22, 527-531. http://dx.doi.org/10.1080/0144361021000003690
[6] Jha, R. and Sayami, G. (2009) Testicular Fine Needle Aspiration in Evaluation of Male Infertility. Journal of Nepal Medical Association, 48, 78-84.
[7] Mehrotra, R. and Chaurasia, D. (2008) Fine Needle Aspiration Cytology of the Testis as the First Line Diagnostic Modality in Azoospermia: A Comparative Study of Cytology and Histology. Cytopathology, 19, 363-368. http://dx.doi.org/10.1111/j.1365-2303.2007.00485.x
[8] Schlegel, P.N. (2009) Non Obstructive Azoospermia: A Revolutionary Surgical Approach and Results. Seminars in Reproductive Medicine, 27, 165-170. http://dx.doi.org/10.1055/s-0029-1202305
[9] Coburn, M. and Wheeler, T.M. (1991) Testicular Biopsy in Male Infertility Evaluation. In: Lipshultz, L.I. and Howards, S.S., Eds., Infertility in Male, 2nd Edition, Mosby Year Book, Philadelphia, 223-253.
[10] Yildiz-Aktas, I.Z., Monaco, S.E., Khalbuss, W.E., et al. (2011) Testicular Touch Preparation Cytology in the Evaluation of Male Infertility. Cyto Journal, 8, 24. http://dx.doi.org/10.4103/1742-6413.91244
[11] European Association of Urology. http://www.Uroweb.Org/professionalresources/guidelines
[12] Amer, M., Haggar, S.E., Moustafa, T., El-Naser, T.A. and Zohdy, W. (1999) Testicular Sperm Extraction: Impact of Testicular Histology on Outcome, Number of Biopsies to be Performed and Optimal Time for Repletion. Human Reproduction, 14, 3030-3034.
http://dx.doi.org/10.1093/humrep/14.12.3030
[13] Schulze, W., Thomas, F. and Knuth, U.A. (1999) Testicular Sperm Extraction: Comprehensive Analysis with Simultaneously Performed Histology in 1418 Biopsies from 766 Subfertile Men. Human Reproduction, 14, 82-96. http://dx.doi.org/10.1093/humrep/14.suppl_1.82
[14] Seo, J.T. and Ko, W.J. (2001) Predictive Factors of Successful Testicular Sperm Recovery in Non-Obstructive Azospermia Patients. International Journal of Andrology, 24, 306-310.
http://dx.doi.org/10.1046/j.1365-2605.2001.00307.x
[15] Tsujimura, A., Matsumiya, K., Miyagawa, Y., Tohda, A., Miura, H., Nishimura, K., et al. (2002) Conventional Multiple or Microdissection Testicular Sperm Extraction: A Comparative Study. Human Reproduction, 17, 2924-2929. http://dx.doi.org/10.1093/humrep/17.11.2924
[16] Rashed, M.M., Ragab, N.M., Shalaby, A.R. and Ragab, W.K. (2008) Patterns of Testicular Histopathology in Men with Primary Infertility. The Internet Journal of Urology, 5, Article No. 8836.
[17] Wong, T.W., Straus, F.H. and Warner, N.E. (1973) Testicular Biopsy in the Study of Male Infertility: II. Posttesticular Causes of Infertility. Archives of Pathology, 95, 160-164.
[18] Colgan, T.J., Bedard, Y.C., Strawbridge, H.T., Buckspan, M.B. and Klotz, P.H. (1980) Reappraisal of the Value of Testicular Biopsy in the Investigation of Infertility. Fertility and Sterility, 33, 56-60.
[19] Brannen, G.E. and Roth, R.P. (1979) Testicular Abnormalities of the Subfertile Male. Journal of Urology, 122, 575-562.
[20] Al-Rayess, M.M. and Al-Rikabi, A.C. (2000) Morphologic Patterns of Male Inferetility in Saudi Patients. A University Hospital experience. Saudi Medical Journal, 21, 625-628.
[21] Thomas, J.O. (1990) Histological Pattern of Testicular Biopsies in Infertile Males in Ibadan, Nigeria. East African Medical Journal, 67, 578-584.
[22] Meinhard, E., McRae, C.U. and Chisholm, G.D. (1973) Testicular Biopsy in Evaluation of Male Infertility. BMJ, 3, 577-581. http://dx.doi.org/10.1136/bmj.3.5880.577
[23] Haddad, F.H., Omari, A.A., Malkawi, O.M., Ajour, W.K., Izat, A., Khasrof, H. and Khawaldeh, A.K. (2004) Patterns of Testicular Cytology in Men with Primary Infertility: Any Change since the Gulf War? Acta Cytologica, 48, 807-812. http://dx.doi.org/10.1159/000326450
[24] “FNA Mapping” (Section FNA Cytology vs Testis Biopsy).

  
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