Testicular Biopsy

적응증

1) Azoospermic male with normal gonadotropin levels (LH and FSH)

- 폐색성 무정자증과 일차성 고환부전증 (primary testicular failure)를 감별

2) Identification of mature sperm for ICSI (Diagnostic)

3) Contralateral identification of malignancy (Diagnostic)

4) Harvesting of sperm for ICSI (Therapeutic)

합병증

hematoma, testicular atrophy (related to vascular injury), infection (rare)

시술방법

anesthesia

① local anesthesia

② general or spinal anesthesia : multiple biopsy가 예상되는 경우 (testicular failure)

Biopsy

Open Biopsy

① Anesthesia

② bilateral (양측 biopsy시) 1cm transverse scrotal incision

③ tunica albuginea(superior lat or med side)를 5-0 polypropylene으로 고정

④ tunica albuginea를 3-4mm incision

⑤ 삐져나온 seminiferous tubule을 다치지 않게 iris scissors로 excise

⑥ specimen을 Bouins, Zenkers, or collidine buffered glutaraldehyde soution에 넣는다 (formalin은 안 된다)

⑦ 고정 했던 실로 tunica albuginea를 close

⑧ tunica vaginalis, skin을 close

Percutaneous Biopsy

- prostate biopsy 때와 같이 16-18 gauge biopsy gun을 이용한다.