Quantitative evaluation of biopty gun testis needle biopsy. Correlation between biopsy score of varicocele-bearing testis and sperm count.

OBJECTIVE

To investigate the applicability of quantitative evaluation of needle biopsy of the testis and any correlation between biopsy score and sperm parameters in infertile or subfertile men with varicocele.

STUDY

DESIGN

A total of 45 infertile men with clinical left varicocele were included in the study. All patients underwent left varicocelectomy and bilateral biopty gun needle biopsy of both testes. Spermiograms were obtained before and three months after the operation. The biopsy specimens were evaluated for Johnsen and Agger score, Leydig cell score, germ cell/Sertoli cell ratio, mean tubular diameter, peritubular fibrosis, and tubular and basement membrane hyalinization.

RESULTS

Mean sperm count, motility and normally configured motile sperm counts increased 20%, 25% and 60% by month 3, respectively (P < .05). We did not observe any significant change in normally configured sperm counts. A mean of 14 tubuli per testis were obtained with single-pass needle biopsy. Johnsen and Agger scores, Leydig cell scores, mean tubular diameter and germ cell/Sertoli cell ratios of both testes were comparable. However, there was significantly less peritubular fibrosis, tubular hyalinization and basal membrane hyalinization in the right testis when compared to the varicocele-bearing left testis (P < .05). We found positive correlations between Johnsen and Agger score of varicocele-bearing left testis and preoperative normally configured motile sperm counts (Pearson's r = .34 and P < .05 and Pearson's r = .41 and P < .05, respectively). The Leydig cell score of varicocele-bearing testis correlated inversely with sperm counts (Pearson's r = -0.37, P < .05).

CONCLUSION

These observations may prove of prognostic value in infertile or subfertile men with varicocele.