Aspiration Biopsy Smear of Testis in Azoospermia: Cytological Versus Histological Examination

Abstract

The diagnostic value of cytological examination of aspiration biopsy smears is compared with that of histological examination of surgically removed biopsy specimens from 59 testes of 42 men with azoospermia. The material was examined regarding spermatogenesis and the possibilities to specify the diagnosis of organic changes found. In the evaluation of the spermatogenetic activity both methods were of equal value. All of the known histological changes occurring in azoospermia could be established in the histological specimens. Complete agreement was found between the results of both methods in the cases of normal testicular morphology and spermatogenic arrest. The other histological diagnoses which to a considerable degree are based on the appearance of the seminiferous tubules and peritubular connective tissue could not be established in aspiration biopsy smears. In all of the patients with a normal histological and cytological appearance of the testis azoospermia were due to obstruction of the epididymis or the spermatic duct. Since only such cases for the present are accessable to curative operative therapy by shunt operation and since both methods distinguished these cases equally well, it would seem justified in clinical practice to limit the investigation in cases of azoospermia to the cytological method with a fine needle. However, for a specified diagnosis a surgical biopsy and histological examination will be required.