Nicholas Raison1, Jake Warrington1, Hussain M Alnajjar2, Asif Muneer3, Kamran Ahmed1,2,4. 1. MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, London, UK. 2. Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK. 3. NIHR Biomedical Research Centre, University College London Hospital, London, UK. 4. Department of Urology, Kings College Hospital, Kings Health Partners, London, UK.
Abstract
BACKGROUND: Radical orchidectomy in patients who are subsequently diagnosed with benign testicular tumours represents an overtreatment due to the deleterious effects on endogenous testosterone, fertility and body image. For these reasons, the option of partial orchidectomy (PO) should be considered in certain groups of patients. Patients with bilateral tumours (synchronous or metachronous) or a solitary testis where the lesion is no greater than 30% of the volume of the testis could be considered for a PO. Evidence has shown that PO is effective for small testicular masses with excellent survival and recurrence rates. OBJECTIVES: Highlight the feasibility of maintaining post-operative fertility or normal semen parameters and endocrine function following PO. MATERIALS AND METHODS: Data for this review were obtained through a search of the PubMed database. Papers were required to be in English and focus on adult human males. RESULTS: Eligible and relevant papers were assessed for data regarding fertility, semen parameters and endocrine function following PO for a small testicular mass (STM). CONCLUSION: It is possible to preserve both fertility and endocrine function after PO. Although patients may still require adjuvant radiotherapy for concomitant intratubular germ cell neoplasia (ITGCN) which results in subfertility, endocrine function is still conserved. However, it is possible to postpone radiotherapy and continue with clinical surveillance for the purposes of fertility preservation.
BACKGROUND: Radical orchidectomy in patients who are subsequently diagnosed with benign testicular tumours represents an overtreatment due to the deleterious effects on endogenous testosterone, fertility and body image. For these reasons, the option of partial orchidectomy (PO) should be considered in certain groups of patients. Patients with bilateral tumours (synchronous or metachronous) or a solitary testis where the lesion is no greater than 30% of the volume of the testis could be considered for a PO. Evidence has shown that PO is effective for small testicular masses with excellent survival and recurrence rates. OBJECTIVES: Highlight the feasibility of maintaining post-operative fertility or normal semen parameters and endocrine function following PO. MATERIALS AND METHODS: Data for this review were obtained through a search of the PubMed database. Papers were required to be in English and focus on adult human males. RESULTS: Eligible and relevant papers were assessed for data regarding fertility, semen parameters and endocrine function following PO for a small testicular mass (STM). CONCLUSION: It is possible to preserve both fertility and endocrine function after PO. Although patients may still require adjuvant radiotherapy for concomitant intratubular germ cell neoplasia (ITGCN) which results in subfertility, endocrine function is still conserved. However, it is possible to postpone radiotherapy and continue with clinical surveillance for the purposes of fertility preservation.
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
Authors: Grzegorz Niemczyk; Łukasz Zapała; Tomasz Borkowski; Waldemar Szabłoński; Piotr Radziszewski; Agnieszka Cudnoch-Jędrzejewska Journal: Cent European J Urol Date: 2021-02-04