Testicular Atrophy Incidence and Clinical Predictors

Incidence in Specific Clinical Scenarios

• Approximately 5-30% of testicular cancer patients have testicular atrophy in the contralateral testis, with the highest risk (~30%) occurring in men with testicular volume <12 ml and age <40 years 1, 2, 3
• The European Association of Urology guidelines note that routine contralateral biopsy is not indicated by most experts, but atrophy represents a high-risk feature 1

Testicular Cancer and Germ Cell Tumors

• Marked testicular atrophy warrants consideration of contralateral testis biopsy when a cryptorchid testis or significant atrophy is present in testicular cancer patients 4

Non-Obstructive Azoospermia

• Testicular atrophy is a characteristic finding in non-obstructive azoospermia, representing primary testicular dysfunction with FSH levels typically >7.6 IU/L 6
• Testicular atrophy does not necessarily preclude sperm retrieval: up to 50% of men with non-obstructive azoospermia and testicular atrophy have retrievable sperm with microsurgical testicular sperm extraction 5, 6