Murat Keske1, Abdullah Erdem Canda2, Ali Fuat Atmaca3, Ozer Ural Cakici4, Muhammed Ersagun Arslan5, Davut Kamaci5, Mevlana Derya Balbay2. 1. University of Health Sciences, Kayseri Training and Research Hospital, Department of Urology, Kayseri, Turkey. 2. Koc University, School of Medicine, Department of Urology, Istanbul, Turkey. 3. Yildirim Beyazit University, School of Medicine, Department of Urology, Ankara, Turkey. 4. Yenimahalle Training and Research Hospital, Department of Urology, Ankara, Turkey. 5. Ankara Ataturk Training and Research Hospital, Department of Urology, Ankara, Turkey.
Abstract
INTRODUCTION: We present oncological and functional outcomes of patients who underwent testis-sparing surgery (TSS). METHODS: Overall, 13 patients were included. Mean patient age was 29.9±12.5 years. In five patients, TSS was performed for sequential bilateral testicular tumours. One patient underwent concurrent left radical orchiectomy and right TSS. In eight patients with normal contralateral testis, seven underwent left and one underwent right TSS. RESULTS: Mean pathological tumour size was 14.6±12.5 mm. Intraoperative frozen section evaluation of the mass was performed in eight patients that revealed benign lesions. No intraoperative tumour bed biopsies were taken in this patient group. Regarding the remaining five patients, intraoperative tumour bed biopsies were taken and testicular intraepithelial neoplasia (TIN) was reported in two (40%) patients; no local testicular radiotherapy was given postoperatively. Tumour pathology was malignant in all but one lesion, including Leydig cell tumour (n=1), seminoma(n=2), embryonal carcinoma (n=1), and adenomatoid tumour (n=1). During 47.2±22.5 months of followup, local recurrence was detected in one patient who underwent radical orchiectomy. No additional local recurrence or systemic metastasis was identified in other patients with malignant lesions. For patients with malignant tumours, of the three patients with a normal preoperative testosterone levels, testosterone level was normal in one patient (with no erectile dysfunction [ED]) and was decreased in two patients (with ED) following TSS. No ED was reported in the nine patients with benign lesions. CONCLUSIONS: In carefully selected cases, TSS appears to be a safe, feasible procedure with adequate cancer control that could preserve sexual function.
INTRODUCTION: We present oncological and functional outcomes of patients who underwent testis-sparing surgery (TSS). METHODS: Overall, 13 patients were included. Mean patient age was 29.9±12.5 years. In five patients, TSS was performed for sequential bilateral testicular tumours. One patient underwent concurrent left radical orchiectomy and right TSS. In eight patients with normal contralateral testis, seven underwent left and one underwent right TSS. RESULTS: Mean pathological tumour size was 14.6±12.5 mm. Intraoperative frozen section evaluation of the mass was performed in eight patients that revealed benign lesions. No intraoperative tumour bed biopsies were taken in this patient group. Regarding the remaining five patients, intraoperative tumour bed biopsies were taken and testicular intraepithelial neoplasia (TIN) was reported in two (40%) patients; no local testicular radiotherapy was given postoperatively. Tumour pathology was malignant in all but one lesion, including Leydig cell tumour (n=1), seminoma(n=2), embryonal carcinoma (n=1), and adenomatoid tumour (n=1). During 47.2±22.5 months of followup, local recurrence was detected in one patient who underwent radical orchiectomy. No additional local recurrence or systemic metastasis was identified in other patients with malignant lesions. For patients with malignant tumours, of the three patients with a normal preoperative testosterone levels, testosterone level was normal in one patient (with no erectile dysfunction [ED]) and was decreased in two patients (with ED) following TSS. No ED was reported in the nine patients with benign lesions. CONCLUSIONS: In carefully selected cases, TSS appears to be a safe, feasible procedure with adequate cancer control that could preserve sexual function.
Authors: Jesse Ory; Udi Blankstein; Daniel C Gonzalez; Aditya A Sathe; Joshua T White; Carlos Delgado; John Reynolds; Keith Jarvi; Ranjith Ramasamy Journal: BJUI Compass Date: 2021-02-23