Department of Reproduction and Ageing, University of Pisa, Pisa, Italy.
Ann Med. 2011 Mar;43(2):83-9. doi: 10.3109/07853890.2010.542173. Epub 2011 Jan 24.
A general consensus on the role of testicular biopsy in non-obstructive azoospermia (NOA) is needed. This paper reviews and updates technical aspects and clinical performance of the percutaneous testicular biopsy techniques, in particular large-needle aspiration biopsy (LNAB), and proposes a flow chart for the management of NOA. The English literature and original data were reviewed or analyzed. Large-needle biopsy (LNB) includes large-needle cutting biopsy (LNCB) and large-needle aspiration biopsy (LNAB). LNCB usually requires scrotal incision for the insertion of relatively large needles. Fine-needle aspiration biopsy (FNAB) does not require surgical equipment or expertise, employs the smallest needles (23- to 20-gauge), and permits sperm cytologic detection. LNAB also does not require surgical equipment or expertise, employs needles of size from 20- to 18-gauge, is safe, and can be used for testicular histology and sperm recovery. An operative flow chart is proposed for the management of NOA in which FNAB, LNAB and open surgical biopsy are used for the optimal management of NOA.
需要就睾丸活检在非梗阻性无精子症（NOA）中的作用达成共识。本文综述和更新了经皮睾丸活检技术，特别是大针头抽吸活检（LNAB）的技术方面和临床性能，并提出了 NOA 管理的流程图。综述了英文文献和原始数据。大针头活检（LNB）包括大针头切割活检（LNCB）和大针头抽吸活检（LNAB）。LNCB 通常需要阴囊切口插入相对较大的针头。细针抽吸活检（FNAB）不需要手术设备或专业知识，使用最小的针头（23-20 号），并允许进行精子细胞学检测。LNAB 也不需要手术设备或专业知识，使用 20-18 号大小的针头，安全，可用于睾丸组织学和精子回收。提出了用于 NOA 管理的手术流程图，其中 FNAB、LNAB 和开放式外科活检用于 NOA 的最佳管理。
