[Clinical application of testicular aspiration biopsy by continuous negative-pressure puncture]

To investigate the characteristics of testicular aspiration biopsy by continuous negative-pressure puncture (CNPP) and sum up the preliminary experience in employing this strategy.

Totally, 271 patients underwent testicular aspiration biopsy in our hospital from August 2002 to December 2014, 88 by open testicular extraction (group A), 87 with a biopsy gun needle (group B), and 96 with a CNPP device (group C). We analyzed the clinical data about the patients and compared the operation time, intraoperative blood loss, postoperative complications, and the success rate of sperm retrieval among the three groups.

The operation time was significantly longer in group A than in B and C (［37.0 ± 14.1］ vs ［7.0 ± 2.1］ and ［6.0 ± 3.1］ min, P < 0.05), the intraoperative blood loss markedly less in group C than in A and B (［1.2 ± 0.6］ vs ［10.2 ± 4.1］ and ［3.1 ± 1.2］ ml, P < 0.05), and the rate of postoperative complications remarkably higher in group A than in B and C (8.0% ［7/88］ vs 4.6% ［4/87］ and 0 ［0/96］, P < 0.05), but with no statistically significant difference in the success rate of sperm retrieval between groups A, B and C (95.4% ［21/22］ vs 97.2% ［35/36］ vs 95.0% ［38/40］, P > 0.05). The success rates of single-extraction sperm retrieval sufficient for intracytoplasmic single-sperm injection (ICSI) in groups A, B and C were 89.4% (59/66), 86.3% (44/51) and 82.1 % (46/56), and those of two-extraction sperm retrieval were 97.0% (64/66), 98.0% (50/51) and 98.2% (55/56), respectively, neither with statistically significant difference between the three groups (P > 0.05).

Testicular aspiration biopsy by CNPP can be completed by one person and yield enough testicular tissue for pathological examination or ICSI. With the advantages of convenient operation, less intraoperative blood loss and few postoperative complications, it has a high clinical application value.