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The role of partial orchidectomy in the management of small testicular tumours: fertility and endocrine function

Research output: Contribution to journalReview article

Nicholas Raison, Jake Warrington, Hussain M Alnajjar, Asif Muneer, Kamran Ahmed

Original languageEnglish
JournalAndrology
DOIs
Publication statusE-pub ahead of print - 13 Mar 2020

Bibliographical note

This article is protected by copyright. All rights reserved.

King's Authors

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 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 partial orchidectomy. Evidence has shown that partial orchidectomy 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 partial orchidectomy.

MATERIALS AND METHODS: Data for this review was 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 partial orchidectomy for a small testicular mass (STM).

CONCLUSION: It is possible to preserve both fertility and endocrine function after partial orchidectomy. 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.

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