Use of biopty gun for transcutaneous testicular biopsies

Needle biopsies are being performed commonly as a substitute for open biopsy in certain patients in whom a tissue diagnosis is necessary to determine therapy. During the last few years the Biopty gun and its through-cut needle have evolved as a satisfactory method to perform prostate biopsy in a rapid and painless manner. To determine whether the Biopty gun could be used to perform testicular biopsies 7 patients underwent this procedure in an outpatient setting. The patients received cutaneous lidocaine and the special through-cut needle (already inserted in the gun) was inserted painlessly through this cutaneous wheal towards the tunica albuginea of the testis. The gun was fired and in less than a fraction of a second a biopsy was obtained. The needle was removed and the tissue was placed in Bouin's solution. In some patients more than 1 biopsy was performed. None of the biopsies took more than 5 minutes, none of the patients required postoperative analgesia and none felt untoward discomfort during the biopsy. All biopsies obtained adequate tissue to diagnose the presence of sperm. These results demonstrate that needle biopsy of the testis with the Biopty gun system is a cost-effective, rapid, safe, relatively harmless and effective way to obtain a testicular biopsy to identify the presence of sperm. With time this percutaneous method may supercede other open and percutaneous methods of testicular biopsy.