Fine needle aspiration cytology compared with open biopsy histology for the diagnosis of azoospermia.
This was a comparative study to determine the diagnostic value of fine needle aspiration of the testis compared with open testicular biopsy in azoospermic men. A total of 34 infertile, azoospermic patients aged from 26-54 years underwent concurrent testicular fine needle aspiration (FNA) and biopsy. The testis was aspirated at three separated sites (upper, middle and lower pole) using a 20 ml syringe and 21-G butterfly needle. A testicular biopsy was taken from the same sites. Samples obtained from FNA were air-dried and stained with Romanowsky-May-Grunwald-Giemsa method. Sections obtained from testicular biopsy were stained with haematoxylin and eosin (H&E). The patient's history, semen analyses, hormonal profile and testicular volume were analysed, and in addition to the histological results azoospermia was classified into obstructive and non-obstructive. A good correlation between cytological smears and histological sections was found in 65 of 68 testes (95.6%). Normal spermatogenesis was diagnosed in seven patients (20.6%), hypospermatogenesis in nine (26.5%), late maturation arrest in five (14.7%), early maturation arrest in three (8.8%) and Sertoli only-cell in 10 (29.4%) patients. Discordance between cytology and histology was observed in three of 68 testes (4.4%) and was related to inadequacy of FNA. Testicular fine needle aspiration is a simple, minimally-invasive procedure that can diagnose accurately testicular function. In addition to the testicular volume and hormonal status, it can differentiate the obstructive from non-obstructive azoospermia. In cases of non-obstructive azoospermia, multiple passes with a fine needle can be performed instead of open testicular biopsy for sperm extraction if present.
Qublan
H S
HS
Department of Obstetrics and Gynecology, King Hussein Medical Center, Amman, Jordan. hqublan@hotmail.com
Al-Jader
K M
KM
Al-Kaisi
N S
NS
Alghoweri
A S
AS
Abu-Khait
S A
SA
Abu-Qamar
A A
AA
Haddadin
Elham
E
D000328:Adult; D001706:Biopsy / Q000379:methods; D001707:Biopsy, Needle / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009845:Oligospermia / Q000473:pathology*; D013737:Testis / Q000473:pathology*; D016896:Treatment Outcome