testis biopsy

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Testis biopsy can be done as an outpatient procedure. Local anesthesia
is adequate for adolescents and adults if supplemented with
analgesics such as midazolam or diazepam. The drawback of local
infiltration is possible injury to the spermatic vessels. An alternative
is to introduce a Biopty gun with a 17-mm sampling notch
percutaneously to obtain one or two cores. In this technique, one
must stabilize the testis and secure the epididymis posteriorly. The
potential disadvantage of this technique is inadvertent and unrecognized
injury to a testicular blood vessel or epididymis. Other
limitations include the small sample volume and distortion of
seminiferous tubule histology.
1. Because of the intragonadal distribution of the arteries in the
tunica vasculosa, the biopsy should be taken from either
the medial or the lateral aspect of the superior pole where theascularity is sparse, not from the well-vascularized anterior

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