Histological patterns of testicular biopsy in patients with azoospermia: single-institution experience

Nina Čamdžić; Višnja Muzika; Samra Čustović; Mirsad Babić; Mirsad Dorić; Edina Lazović Salčin; Suada Kuskunović-Vlahovljak

doi:10.2478/amma-2023-0038

Nina Čamdžić Department of Pathology, Faculty of Medicine University of Sarajevo
Višnja Muzika Department of Histology and Embryology, Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
Samra Čustović Department of Histology and Embryology, Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
Mirsad Babić Department of Pathology, Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
Mirsad Dorić Department of Pathology, Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
Edina Lazović Salčin Department of Pathology, Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
Suada Kuskunović-Vlahovljak Department of Pathology, Faculty of Medicine, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina

DOI: https://doi.org/10.2478/amma-2023-0038

Keywords: infertility, histology, testis

Abstract

Objective of this study was to identify the histopathological patterns and their frequency in testicular biopsy specimens from azoospermic patients and to categorize it according to Modified Johnson scoring system.

Methods: Testicular biopsies from male patients with clinical diagnosis of azoospermia were included in this study. All tissue samples were fixed in buffered 10% formalin, routinely processed and stained with Hematoxylin and Eosin. All cases were examined microscopically and categorized according to the histopathological patterns and Modified Johnson scoring system.

Results: Total 219 cases of testicular biopsies from 125 azoospermic male patients were evaluated, with 94 cases of bilateral testicular biopsy. The most prevalent age group was of 30-39 years (66.2%). The most common histological pattern was of Sertoli cell only syndrome (58.4%) while the least represented pattern was germ cell maturation arrest, seen in 4.6% cases. The most common Modified Johnsen score was 2 (66.7%). There was discordance in histologic pattern in both testes in 12.76% of patients who had bilateral testicular biopsy.

Conclusion: Our study gives an insight on the most common histopathological patterns of azoospermic patients and emphasizes the need for a better national statistics and epidemiological studies of this entity. It also points out the significance of the bilateral testicular biopsy, as both, diagnostic and therapeutic procedure.

Keywords: infertility, histology, testis