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Volume 18, Issue 1 (January 2016) 18, 21–24; DOI:10.4103/1008-682X.156637

Testicular fine-needle aspiration for the assessment of intratesticular hormone concentrations

Ada P Lee1, Mara Y Roth2, Jean-Jacques Nya-Ngatchou2, Kat Lin3, Thomas J Walsh4, Stephanie T Page2, Alvin M Matsumoto5, William J Bremner2, John K Amory2, Bradley D Anawalt2

1 Department of Medicine, University of California San Francisco, San Francisco, CA, USA
2 Department of Medicine and Center for Research in Reproduction and Contraception, University of Washington, Seattle, WA, USA
3 Department of Obstetrics and Gynecology, University of Washington, Seattle, WA, USA
4 Department of Urology, University of Washington, Seattle, WA, USA
5 Department of Medicine and Center for Research in Reproduction and Contraception, University of Washington; Department of Medicine, Geriatric Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA

Correspondence: Dr. BD Anawalt (banawalt@medicine.washington.edu)



Measurement of intratesticular sex steroid concentrations in men informs both the development of male hormonal contraceptives and the understanding of male infertility. Given the challenges of using invasive techniques to measure testicular hormone physiology, our group has used a minimally-invasive fine-needle aspiration technique to measure intratesticular hormones in normal healthy men. Herein, we present a post-hoc analysis of the safety and efficacy of testicular fine-needle aspiration (FNA) completed as part of six clinical trials. From 2001 through 2011, a total of 404 procedures were conducted among 163 research volunteers, 85.9% of which were successful in obtaining sufficient fluid for the measurement of intratesticular steroid concentrations. Pain was the most common side effect, with 36.8% of procedures associated with moderate procedural pain and 4.7% with severe procedural pain. Postprocedural pain was uncommon and abated within a few days. Mild local bruising occurred with 14.9% of procedures. Two serious adverse events (0.5%) required surgical intervention. The risk of an adverse event was not associated with age, body mass index, testicular size, or the volume of fluid aspirated. Testicular FNA to obtain fluid for measurement of intratesticular steroid concentrations frequently causes mild to moderate procedural pain, but serious adverse events occur rarely. Testicular FNA has been instrumental for defining human intratesticular hormone physiology and is a minimally-invasive, safe, effective method for obtaining fluid for research on testicular physiology and pathology.

Keywords: male contraception; physiology; reproductive and urinary; testis

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