Testicular biopsy in Egypt is mainly used in the diagnosis and treatment of male infertility.
It is realized to understand the causes of azoospermia and, in the case of obstructive azoospermia (obstruction of the tube through which sperm moves from the testicles to the urethra), to retrieve live spermatozoa for in vitro fertilization.
Testicular biopsy consists of two different techniques, it depends on the case of each patient and this is realized in order to obtain testicular tissue with spermatozoa.
The obtained testicular material is fractionated; one part is destined for reproductive techniques and the other part for its study.
Analyzing the testicular tissue allows us to evaluate its capacity to produce spermatozoa and to discover the point at which spermatogenesis interrupts this production.
Testicular biopsy price in Egypt
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What are the types of the Testicular biopsy procedure ?
Fine Needle Aspiration Biopsy (FNAB) :
Fine Needle Aspiration Biopsy, often abbreviated as FNAB, is a minimally invasive procedure used to obtain tissue samples from the testicles for diagnostic evaluation.
During this procedure, a thin needle is inserted into the testicle to extract a small amount of tissue for analysis under a microscope.
FNAB is particularly useful in diagnosing conditions such as testicular masses or lumps, allowing for the identification of cancerous or non-cancerous growths within the testicular tissue.
It is a relatively quick and outpatient procedure, typically performed under local anesthesia to minimize discomfort for the patient. FNAB offers high precision in targeting specific areas of concern within the testicle, aiding clinicians in making accurate diagnostic assessments and informing subsequent treatment decisions.
Open Surgical Biopsy :
Open Surgical Biopsy is a more invasive procedure that involves making a small incision in the scrotum or groin area to access the testicle directly.
Once the testicle is exposed, a tissue sample is extracted for histological examination. This type of biopsy is often performed when other less invasive methods, such as FNAB, are not feasible or when a larger tissue sample is required for a more comprehensive analysis.
Open Surgical Biopsy allows for the evaluation of the testicular architecture and cellular composition in greater detail, enabling clinicians to diagnose conditions such as testicular cancer, inflammation, or atrophy with higher accuracy.
Despite being a surgical procedure, advancements in surgical techniques have led to reduced post-operative discomfort and faster recovery times for patients undergoing open surgical biopsy.
Percutaneous Biopsy :
Percutaneous Biopsy is a technique that involves accessing the testicle through the skin using a needle-guided approach, similar to FNAB but with a slightly larger needle.
This procedure is often performed under local anesthesia and guided by imaging techniques such as ultrasound to ensure precise targeting of the biopsy site.
Percutaneous biopsy allows for the collection of larger tissue samples compared to FNAB, making it suitable for diagnosing a wider range of testicular conditions, including tumors, infections, and hormonal abnormalities.
The collected tissue is then examined by a pathologist to provide insights into the underlying pathology and guide further management strategies. Percutaneous biopsy offers a balance between invasiveness and diagnostic yield, making it a valuable tool in the evaluation of testicular health.
Microdissection Testicular Sperm Extraction (Micro-TESE) :
Microdissection Testicular Sperm Extraction, commonly referred to as Micro-TESE, is a specialized procedure primarily used in the management of male infertility.
Unlike traditional biopsies aimed at diagnosing testicular pathology, Micro-TESE focuses on retrieving viable sperm for use in assisted reproductive techniques such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).
During Micro-TESE, a urologist utilizes high-powered microscopes to identify areas within the testicle that are likely to contain sperm-producing tubules. These tubules are then meticulously dissected and sampled to isolate sperm cells while minimizing damage to the surrounding tissue.
Micro-TESE offers higher success rates in sperm retrieval compared to conventional biopsy methods, particularly in cases of non-obstructive azoospermia where sperm production is impaired.
By selectively harvesting sperm from the most viable areas of the testicle, Micro-TESE maximizes the chances of successful fertilization and pregnancy for couples struggling with male factor infertility.
Core Needle Biopsy :
Core Needle Biopsy is a procedure that involves using a larger, hollow needle to obtain a cylindrical core of tissue from the testicle for examination.
This technique allows for the collection of a more substantial tissue sample compared to fine needle aspiration, enhancing the diagnostic yield and accuracy of the biopsy.
Core Needle Biopsy is particularly valuable in cases where a deeper tissue penetration is necessary to assess lesions or abnormalities within the testicular parenchyma. The collected tissue core is then processed and analyzed histologically to identify cellular changes indicative of various testicular pathologies, including tumors, inflammation, and fibrosis.
Core Needle Biopsy offers a balance between invasiveness and diagnostic precision, making it a versatile tool in the evaluation of testicular health.
Laparoscopic Biopsy :
Laparoscopic Biopsy is a minimally invasive surgical procedure performed under general anesthesia, where a small camera (laparoscope) and specialized instruments are inserted into the abdomen through tiny incisions.
This technique allows for visualization and access to the testicles from within the abdominal cavity, facilitating biopsy of the testicular tissue under direct visualization.
Laparoscopic Biopsy is particularly useful in cases where the testicles are difficult to access through traditional scrotal or groin approaches, such as in cases of undescended testicles (cryptorchidism) or previous scrotal surgeries.
By providing a clear view of the testicular anatomy, laparoscopic biopsy allows for precise targeting of biopsy sites and minimizes the risk of injury to surrounding structures. It is often employed in the evaluation of infertility, suspected testicular masses, or other complex testicular conditions requiring detailed assessment.
Ultrasound-Guided Biopsy :
Ultrasound-Guided Biopsy involves the use of real-time ultrasound imaging to visualize the testicle and guide the biopsy needle to the target site with pinpoint accuracy. This technique allows clinicians to precisely target lesions or abnormalities identified on ultrasound, ensuring optimal sampling of the affected tissue for diagnostic purposes.
Ultrasound-guided biopsy is particularly beneficial in cases where palpable abnormalities are not readily apparent or when lesions are located deep within the testicular parenchyma. By providing dynamic imaging guidance, ultrasound helps enhance the safety and efficacy of the biopsy procedure while minimizing the risk of complications.
Ultrasound-guided biopsy is widely utilized in the evaluation of testicular masses, suspected tumors, and other focal lesions, enabling clinicians to obtain high-quality tissue samples for accurate diagnosis and treatment planning.
Testicular Mapping Biopsy :
Testicular Mapping Biopsy is a specialized procedure used in the assessment of spermatogenesis and sperm production within the testicles, particularly in cases of male infertility.
During this procedure, multiple tissue samples are obtained from different regions of the testicle to map the distribution and quality of sperm-producing tubules.
Testicular mapping biopsy provides valuable information about the spatial distribution of sperm production within the testicle, helping clinicians identify areas with the highest sperm yield for subsequent sperm retrieval procedures such as Microdissection Testicular Sperm Extraction (Micro-TESE).
By optimizing the selection of biopsy sites based on spermatogenic activity, testicular mapping biopsy enhances the success rates of sperm retrieval and improves outcomes for couples undergoing assisted reproductive techniques.
This procedure plays a crucial role in personalized treatment planning for men with infertility, guiding clinicians in selecting the most effective sperm retrieval strategy tailored to individual patient needs.
Why undergoing a testicular biopsy ?
Testicular biopsy Egypt may be performed in the following cases :
- to determine the cause of a man's infertility, if other tests have failed to identify it (for example, in cases of azoospermia or absence of sperm in the semen)
- in some cases (in men with azoospermia due to ductal obstruction) to collect sperm and perform an intracytoplasmic sperm injection.
- if the testicles are examined by palpation or ultrasound and a lump or abnormality is found, a biopsy can determine whether it is a cancerous mass or not. However, in most cases, if cancer is suspected, the entire affected testicle is removed (orchiectomy) without delay.
How to prepare for a Testicular biopsy procedure ?
Medical Evaluation :
Before the biopsy, your healthcare provider will conduct a thorough medical evaluation to assess your overall health status and identify any underlying medical conditions or risk factors that may impact the procedure.
This evaluation may include reviewing your medical history, performing a physical examination, and conducting relevant laboratory tests or imaging studies to gather essential information about your health status.
Discussion with Healthcare Provider :
It's essential to have a detailed discussion with your healthcare provider about the purpose of the biopsy, potential risks and benefits, and any alternative diagnostic or treatment options available. Take this opportunity to ask any questions or express any concerns you may have about the procedure to ensure you are fully informed and prepared for what to expect.
Consent Form :
Before the biopsy, you will be asked to sign a consent form indicating that you understand the purpose of the procedure, its potential risks and benefits, and that you consent to undergo the biopsy.
Be sure to carefully read the consent form and ask your healthcare provider to clarify any terms or information that you do not understand before signing.
Medication Review :
Inform your healthcare provider about any medications you are currently taking, including prescription medications, over-the-counter drugs, supplements, or herbal remedies. Some medications may need to be adjusted or temporarily discontinued before the biopsy to reduce the risk of bleeding or other complications during the procedure. Follow your healthcare provider's instructions regarding medication management closely.
Fasting :
Depending on the type of biopsy and the anesthesia used, you may be required to fast for a certain period before the procedure.
This typically involves abstaining from food and drink for a specified amount of time before the scheduled biopsy to reduce the risk of aspiration (inhaling food or fluids into the lungs) during anesthesia. Follow your healthcare provider's instructions regarding fasting carefully to ensure the procedure can be performed safely.
Arrangements for Transportation :
If the biopsy requires sedation or anesthesia, make arrangements for someone to accompany you to the appointment and drive you home afterward. Sedation or anesthesia can temporarily impair your coordination, reflexes, and judgment, making it unsafe for you to drive or operate machinery immediately after the procedure.
Having a responsible adult available to assist you with transportation is essential for your safety and well-being.
Clothing and Personal Items :
Wear comfortable, loose-fitting clothing to the biopsy appointment, as you may be asked to change into a hospital gown before the procedure.
Leave any valuables, jewelry, or accessories at home, and bring only essential personal items with you to the appointment. Follow any specific instructions provided by your healthcare provider regarding clothing or personal items to ensure a smooth and comfortable experience.
Follow Pre-Procedure Instructions :
Your healthcare provider may provide you with specific pre-procedure instructions to follow in the hours or days leading up to the biopsy.
This may include guidelines for hygiene, skin preparation, or other measures to optimize the safety and effectiveness of the procedure. Be sure to adhere to these instructions closely and contact your healthcare provider if you have any questions or concerns
Testicular biopsy Egypt :how is it performed ?
Before a testicular biopsy Egypt which is performed by a urological surgeon, you must consult your surgeon to examine you, evaluate your health and informs you about all the process of this procedure : its aim, results, recovery time…
You should also tell him if you suffer from certain diseases and about all the medications you are taking as there are some medicines that must be avoided before the procedure such as anticoagulants, medications affecting blood clotting, nonsteroidal anti inflammatory drugs…
This procedure is performed under general anaesthesia, so, you must stop eating, drinking and smoking 9 hours before the operation.
Smoking must be avoided 6 to 8 weeks before the testicular biopsy.
A testicular biopsy for sperm retrieval is realized under general anaesthesia and it may be performed in two different ways :
Open surgical biopsy :
The surgeon will make an incision in the scrotal skin in order to obtain a sample of testicular tissue, then, the incision will be closed using stitches or sutures.
The same technique is performed on the other testicle.
Percutaneous biopsy :
This technique does neither need to make an incision, nor stitches or sutures, but, a thin needle will be inserted through the scrotal skin so as to obtain a sample of tissue which is drawn into a syringe attached to the needle.
The same technique is performed on the other testicle.
Testicular biopsy Egypt :aftercare and recovery
After testicular biopsy Egypt, you must follow all the recommendations of your surgeon :
- -Avoid taking aspirin for a period of 1 to 2 weeks after the procedure
- -It is recommended to wear slightly tight underwear in the days following the operation to minimize the risk of hematoma. Furthermore, bathing and swimming are not recommended during the postoperative month until the healing is complete
- -Sexual intercourses must be avoided in the 2 weeks following the procedure
- -Keep the operated area dry for several days after the operation.
- -Swelling and discomfort can appear in the first postoperative days which is normal.
- Your surgeon will inform you about all the postoperative effects of this procedure.
Testicular biopsy Egypt :results
A sample of testicular tissue obtained during the procedure of testicular biopsy Egypt is sent for pathological examination by an anatomapathologist to identify sperm defects such as :
- The degree of spermatogenesis in the testes
- Testicular inflammation or infection
- Spermatocele
- Testicular cancer
- The results will be ready after about 72 hours.
The surgeon will discuss the results with you and suggest additional tests or treatments, depending on the identified problem.
What are the risks of testicular biopsy procedure ?
Bleeding :
Bleeding is a potential risk associated with any invasive procedure, including testicular biopsy. While bleeding is usually minimal and resolves on its own, in rare cases, excessive bleeding (hemorrhage) may occur, leading to complications that require medical intervention.
Infection :
There is a small risk of infection following testicular biopsy, particularly if proper sterile techniques are not followed during the procedure. Infection may manifest as pain, swelling, redness, or discharge at the biopsy site. Prompt medical attention is necessary if signs of infection develop.
Pain and Discomfort :
It is common to experience some degree of pain or discomfort during and after the biopsy procedure. This discomfort typically resolves within a few days and can be managed with over-the-counter pain medications or prescribed pain relievers if necessary.
Scrotal Hematoma :
A scrotal hematoma refers to the collection of blood within the scrotum, resulting from bleeding during or after the biopsy. While small hematomas may resolve on their own without intervention, larger hematomas may cause pain, swelling, and bruising, requiring drainage or other medical management.
Spermatic Cord Injury :
In rare cases, there is a risk of injury to the spermatic cord or other nearby structures during the biopsy procedure. Damage to the spermatic cord may result in complications such as testicular ischemia (reduced blood flow to the testicle), impaired sperm production, or chronic pain.
Allergic Reaction :
Some individuals may experience allergic reactions to medications, anesthesia, or contrast agents used during the biopsy procedure. Allergic reactions can range from mild skin irritation to severe anaphylaxis, a life-threatening condition that requires immediate medical attention.
Fertility Implications :
While testicular biopsy is generally considered safe, there is a theoretical risk of impairing sperm production or fertility, particularly if complications occur or if the procedure is performed in individuals with pre-existing fertility issues. However, in many cases, any potential impact on fertility is minimal and temporary.
Rare Complications :
Although rare, other potential complications of testicular biopsy may include injury to surrounding structures, such as the vas deferens or epididymis, nerve damage, persistent pain, or the development of chronic conditions such as granulomas (localized inflammation).