1998
From: American Urological Association
Fertility Update On Nerve Sparing RPLND In Clinical Stage 1 Nonseminoma Testicular cancer occurs most commonly in young and middle-aged men. After surgical removal of the testis, patients often undergo retroperitoneal lymph node dissection (RLND), particularly if they have a stage 1 nonseminomatous germ cell testicular cancer which has high potential for relapse. These investigators performed nerve-sparing RLND on 483 stage 1 nonseminomatous germ cell testicular cancer patients between 1984 and 1996. The objective of this study was to review the long-term fertility preserving potential of the procedure. They found that of the 401 patients available for followup, 100% were able to achieve ejaculation. They also found that of 50 patients who had attempted pregnancy out of the 124 right-sided procedure males who reported fertility status, 40 (80%) had been successful. Of the 185 left-sided procedure patients who reported fertility status, 48 had attempted pregnancy with 42 (88%) being successful. The researchers conclude that nerve-sparing RLND effectively preserves emission, ejaculation, and long-term fertility. According to them, patients can be advised, that the procedure has no impact on long-term fertility in stage 1 disease, and should there be an effect it is probably due to any chemotherapy administered.
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