Portal de Periódicos da CAPES

SPERMATOGENESIS AFTER UNILATERAL ORCHIECTOMY FOR TESTICULAR CANCER IN PATIENTS FOLLOWING SURVEILLANCE POLICY

2001; Lippincott Williams & Wilkins; Volume: 165; Issue: 1 Linguagem: Inglês

10.1097/00005392-200101000-00023

1527-3792

Kari Dolven Jacobsen, L Theodorsen, Sophie D. Fosså,

Sperm and Testicular Function

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jan 2001SPERMATOGENESIS AFTER UNILATERAL ORCHIECTOMY FOR TESTICULAR CANCER IN PATIENTS FOLLOWING SURVEILLANCE POLICY K.D. JACOBSEN, L. THEODORSEN, and S.D. FOSSA K.D. JACOBSENK.D. JACOBSEN , L. THEODORSENL. THEODORSEN , and S.D. FOSSAS.D. FOSSA View All Author Informationhttps://doi.org/10.1097/00005392-200101000-00023AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Only limited information is available on the natural course of spermatogenesis in patients with testicular cancer who underwent unilateral orchiectomy and surveillance. We analyze long-term exocrine function of the remaining testicle in patients following surveillance policy. Materials and Methods: Sperm counts and serum follicle-stimulating hormone (FSH) levels were available in 60 nonrelapsing cases approximately 3 weeks (baseline), 1 year and 2 years or greater after orchiectomy. Contralateral testicular cancer subsequently developed in 2 men. Results: At baseline 36 patients were normospermic (10 or greater × 106/ml.), 7 were azoospermic and 17 were oligospermic. After 1 year 45 patients were normospermic. Mean sperm concentrations increased significantly from 26 to 39 × 106/ml. during year 1 after orchiectomy. Elevated serum FSH at baseline was associated with incomplete recovery of spermatogenesis, although sperm counts improved in 3 of 7 patients. Furthermore, in the 2 initially oligospermic patients with subsequent contralateral testicle cancer transient normospermia was observed after 1 year. After orchiectomy fatherhood was recorded in 28 men and was assisted by fertilization using fresh semen in 2. Conclusions: In nonrelapsing testicular cancer cases on surveillance, initially reduced spermatogenesis recovers during year 1 after orchiectomy especially if baseline serum FSH is normal. Transient recovery also occurs in patients in whom contralateral testicular cancer subsequently develops. In high risk patients and in initially oligospermic patients with plans for future fatherhood, the period of improved spermatogenesis may be used for multiple semen cryopreservations enabling subsequent assisted fertilization. References 1 : Testicular cancer. Acta Oncol1988; 27: 439. Google Scholar 2 : Long-term sequelae of treatment for testicular germ cell tumours. Br J Cancer,1990; 62: 655. Google Scholar 3 : Long-term recovery of spermatogenesis after radiotherapy in patients with testicular cancer. Radiother Oncol,1990; 18: 117. Google Scholar 4 : Nerve-sparing retroperitoneal lymphadenectomy with preservation of ejaculation. J Urol1990; 144: 287. Link, Google Scholar 5 : Fertility after chemotherapy for testicular germ cell cancers. J Clin Oncol,1997; 15: 239. Google Scholar 6 : Ejaculation in testicular cancer patients after post-chemotherapy retroperitoneal lymph node dissection. Br J Cancer,1999; 80: 249. Crossref, Medline, Google Scholar 7 : Paternity in men with stage I testis tumors on surveillance. J Clin Oncol,1998; 16: 733. Crossref, Medline, Google Scholar 8 : Endocrine and exocrine profiles of men with testicular tumors before orchiectomy. J Urol1987; 137: 420. Link, Google Scholar 9 : Orchidectomy alone in testicular stage I non-seminomatous germ-cell tumours. Lancet,1982; 2: 678. Google Scholar 10 WHO Laboratory Manual for the Examination of Human Semen and Semen-Cervical Mucus Interaction. New York: Cambridge University Press1992. Google Scholar 11 : Frequency distribution of sperm counts in fertile and infertile males. Fertil Steril,1977; 28: 1310. Google Scholar 12 : Structure, function and development of the human testis. In: Pathology of the Testis. Edited by . Oxford: Blackwell1976: 1. chapt. 1. Google Scholar 13 : Spermatogenesis and hormonal status after orchiectomy for cancer and before supplementary treatment. Eur Urol1984; 10: 173. Google Scholar 14 : Exocrine function of testis with germinal testicular tumour. Br Med J1983; 286: 1849. Google Scholar 15 : Recovery of impaired pretreatment spermatogenesis in testicular cancer. Fertil Steril,1990; 54: 493. Google Scholar 16 : Testicular cancer: abnormal structure and function of the contralateral testis. Int J Androl,1983; 6: 209. Google Scholar 17 : Screening for carcinoma in situ of the contralateral testis in patients with germinal testicular cancer. Br Med J (Clin Res Ed),1982; 285: 1683. Google Scholar 18 : Paternity in a patient with seminoma and carcinoma in situ in a solitary testis treated by partial orchidectomy. B J U Int,1999; 84: 374. Google Scholar 19 : Cryopreservation of human semen. In: Andrology: Male Reproductive Health and Dysfunction. Edited by . New York: Springer1997: 349. chapt. 18. Google Scholar 20 : Testicular tumours—introduction. In: Pathology of the Testis. Edited by . Oxford: Blackwell1976: 139. Google Scholar From the Department of Medical Oncology and Radiotherapy, Central Laboratory, The Norwegian Radium Hospital, Oslo, Norway© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetails Volume 165Issue 1January 2001Page: 93-96 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordshealth surveysfertilitycarcinomatestisMetricsAuthor Information K.D. JACOBSEN More articles by this author L. THEODORSEN More articles by this author S.D. FOSSA More articles by this author Expand All Advertisement PDF downloadLoading ...