Cytology of testicular changes in leprosy.
OBJECTIVE
To study the changes in testicular aspirates and semen of patients with leprosy.


METHODS
A prospective study of 56 patients in the reproductive-age group, with no record of treatment for leprosy. Both Ridley-Jopling and WHO classification systems were used. Skin and/or nerve biopsies were performed for documentation of the diagnosis. Semen analysis and fine needle aspirates of the testes were performed. Smears from the testicular aspirates were stained with May-Grünwald-Giemsa and Ziehl-Neelsen stain.


RESULTS
Five patients were unable to produce an ejaculate. Abnormal semen analysis and/or testicular aspirates were seen in 24 (42.8%) patients. Eleven had oligospermia and eight azoospermia. Abnormalities in testicular aspirates ranged from hypospermatogenesis (4) through maturation arrest (1) and atrophy (11). Two patients had hydrocoele, and two had associated microfilariae. Three patients with multibacillary leprosy had type 2 reaction. Mycobacterium lepre was demonstrable in testicular aspirates from all patients with multibacillary and in three with paucibacillary leprosy.


CONCLUSIONS
Abnormal semen analysis and/or testicular aspirates occur in a very high percentage of patients with leprosy. While this is expected for multibacillary disease, the high incidence in the paucibacillary form was surprising. With the rapid elimination of leprosy, fertility-related disability might emerge as a major problem in these people.
Singh
Navjeevan
N
Departments of Pathology and Dermatology, University College of Medical Sciences, Guru Tegh Bahadur Hospital, Delhi, India.
Arora
V K
VK
Jain
Annu
A
Bhattacharya
S N
SN
Bhatia
Arati
A
D000328:Adult; D001707:Biopsy, Needle; D006801:Humans; D007918:Leprosy / Q000382:microbiology / Q000473:pathology*; D008297:Male; D012661:Semen / Q000166:cytology*; D013091:Spermatogenesis; D013737:Testis / Q000473:pathology*