Biopsy - Testicles

This procedure involves the removal of a piece of the testicle. It can be done as part of an infertility workup or to see if a lump is cancerous.

This procedure involves the removal of a piece of the testicle. It can be done as part of an infertility workup or to see if a lump is cancerous.

A testicle biopsy is the removal of a piece of testicular tissue. It can be done as part of an infertility workup or to check for the presence of abnormal, or cancerous, cells.

  • The testicles are two glands that are part of the male reproductive system. They are located in the scrotum, a sack that sits behind the penis.
  • The primary function of the testicles is to produce sperm and testosterone (a male hormone).

Your healthcare provider may recommend an ultrasound and biopsy of your testicles if:

  • You are having problems with infertility
  • He wants to examine your sperm
  • You have a lump on one of your testicles

There are two different ways to do a testicle biopsy. Depending on the circumstances, your healthcare provider will determine which method is best for you.

  • Needle biopsy – The surgeon removes a small piece of tissue using a small needle inserted into a testicle. A medication is injected into the area to numb it before the biopsy. This type of biopsy makes a very small hole, so there is less chance of infection or scarring. However, the results may not be as accurate because it is possible to miss cancerous cells. A needle biopsy is usually done in a healthcare provider's office.
  • Incisional or open biopsy – The surgeon makes an incision in the scrotum and removes a piece of tissue from a testicle. A medication is injected into the area to numb it before the biopsy. Sutures are usually needed to close the incision. This type of biopsy makes a small cut made in the skin, so there is a greater chance of infection or scarring. However, the results are usually more accurate because there is less of a chance the surgeon will miss cancerous cells. An open biopsy is usually done in an operating room at a surgical center or hospital. In some cases, it can be done in an office.

The costs for this care path are for an open biopsy, performed in an outpatient facility.

It is not known for sure what causes testicular cancer. Several factors may increase your chance of developing testicular cancer are:

  • Age – Men between the ages of fifteen and thirty-four
  • Abnormal testes development – Men who have a history of abnormal testes development or undescended testes
  • Medical history – Men who have a previous history of testicular cancer
  • Family history – Men who have a family history of testicular cancer
  • Chemical exposure – Men who have a history of exposure to certain chemicals
  • Klinefelter syndrome – Men who have an extra X chromosome (Klinefelter syndrome)
  • Race – Caucasian men have a higher risk than African-American or Asian-American men do
  • HIV Infection – Men who have HIV may have an increased risk of developing testicular cancer

There is no conclusive link between having a vasectomy and developing testicular cancer.

There may be no symptoms in the early stages of testicular cancer. Some of the symptoms that can develop include:

  • Pain, discomfort or heaviness in the testicles or scrotum
  • Lower back or abdominal pain
  • A testicle that has become larger, has a lump or feels different than usual
  • Enlarged breasts, which also can occur in teenage boys who do not have testicular cancer

As the cancer advances, other symptoms can develop. These symptoms can affect the:

  • Lungs
  • Abdomen and pelvis
  • Back
  • Brain

Contact your healthcare provider if you have any of the above symptoms. He or she will review your symptoms and perform a physical examination, which may include shining a flashlight through your scrotum. Your provider may also recommend one or more of the following:

  • Blood tests
  • X-rays
  • Ultrasounds

A biopsy may be needed to determine if any abnormal findings are related to cancer. If the biopsy or initial testing indicates you have testicular cancer, more testing (CT scan or MRI) may be needed.

If your healthcare provider recommends a testicle biopsy, prior to the procedure tell them about any medications you are taking (including over-the-counter medications and supplements). You should also ask about specific instructions you should follow before and after the procedure. These include:

  • Medications you should not take before the procedure, such as blood thinners
  • Regular medications you should continue to take on the day of your procedure
  • How many hours you should stop eating and drinking before the procedure

There should not be a lot of pain during the actual biopsy. However, sometimes the numbing medication can burn when it is injected into the scrotum.

Contact your healthcare provider if you have symptoms of testicular cancer. Be prepared to discuss any symptoms you have and how long you've had them.

  • Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations).
  • Make a list of your medications (including over-the-counter).
  • Write down any questions, symptoms or concerns you want to talk about.
  • If your healthcare provider prescribes a medication for you, ask for a generic version. If your doctor thinks that a generic version is not right for you, ask for a medication on the lowest available tier of your Prescription Drug List (PDL).

What should I ask my healthcare provider before having a testicle biopsy?

  • What is my diagnosis and reason for the procedure? Are there any alternatives? What are the benefits and risks of each?
  • What are the possible complications for this procedure?
  • What happens if I do not go through with the procedure?
  • What is your experience in doing this type of procedure? What is your complication rate?
  • Is there any special preparation for the procedure? (If so, get clear instructions on what you need to do.)
  • Will I need anesthesia? What are the possible side effects?
  • How will I feel after the procedure? Will I have to modify my activity?
  • What other specialists will need to get involved?

Do not forget to arrange for transportation to and from the facility and for help at home.

After your procedure, you should know what you had done, what medication was given and what symptoms you should report to your healthcare provider after discharge. Make sure you understand all home care instructions (including medications and side effects) and follow-up plans. Your surgeon should also communicate with your primary care physician.


Also known as:

Testicle Biopsy
Biopsy - Testicles
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