Kitilla Tadesse
Department of Obstetrics and Gynecology, Medical Faculty, Addis Ababa University, Addis Ababa, Ethiopia.
Ethiop Med J. 2007 Jan;45(1):19-28.
This case series study aimed to find the relation of testicular volume with fine- needle aspiration cytology results in azoospermic infertile males to indicate the probable reason for azoospermia.
After clinical examination and two basic semen analyses, fine- needle aspiration and cytology study was performed on 221 testicles of 112 men.
primary infertility was 87% and about 88% were town dwellers. The mean age and duration of infertility was 35 and 6 years respectively. History of scrotal swelling and/or sexually transmitted infection was present in 37% and two-third of the other medical problems was tuberculosis. Bilateral scrotal testicles and epididymis were palpated in 109 males, of which 92% had symmetrical testicles and 35% abnormal epididymis. Among the normal consistent testicles, 64% and 25% were normal and small in size respectively. Normal size with soft consistency was 5% and others make 4%. Mature sperm cells were identified in 51% of the fine needle-aspiration cytology report, and in 93% of the normal size testicles. The rest were spermatogenic arrest 38%, sertoli cell-only 7%, and spermatocele 2%. Early maturation arrest was observed in 65% of the small and 10% of the normal testicles (p = 0.000001). Sertoli cell only syndrome were also significantly higher in small testicles compared to the normal (P < 000001)
Complete spermatogenesis was more associated with normal size testicles while spermatogenic arrest was mostly in the small size testicles. Azoosperrmic males with normal size testicles and complete spermatogenesit most likely have duct obstruction while those with small testicles were likely to suffer from incomplete spermatogenesis. Small testicles and atrophic testis may have destructive form (3%).
The size of the testicle assessed by the Prader orchidometer allows a rough evaluation of the underlying cause of infertility. In two-thirds of the normal sized testicles, complete spermatogenesis was detected while 51% and 19% of the small testicles exhibited maturation arrest and Sertoli cell-only syndrome respectively.
