Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Sex Med Rev. 2018 Jul;6(3):396-409. doi: 10.1016/j.sxmr.2017.12.007. Epub 2018 Feb 1.
Urological survivorship issues encompass an area that may potentially be overlooked after treatment of childhood cancer in adolescent boys and young men. Side effects of cancer therapy may include subsequent development of erectile dysfunction (ED), hypogonadism, and infertility in adulthood.
The purpose of this review is to focus on the etiology and prevalence of the range of sexual and gonadal dysfunction in adolescent boys and young men who are cancer survivors, while discussing current recommendations for evaluation and treatment.
We performed a literature review of articles evaluating hypogonadism, sexual dysfunction, ED, and infertility in young men cancer survivors.
There is compelling evidence that significant survivorship issues are faced by boys entering adulthood after completing cancer therapy.
Overall, young men cancer survivors are much more likely to report symptoms of sexual dysfunction than the general population of men. These patients can develop ED due to physiologic and psychological changes that take place with diagnosis of a malignancy and subsequent treatment. Primary hypogonadism can arise due to pelvic radiation or chemotherapy, and central hypogonadism may arise from pituitary insufficiency after brain radiation or surgery. Infertility develops from direct damage to the Sertoli cells and germinal epithelium from radiotherapy or chemotherapy. Cancer survivors who are men should therefore be screened for these important urological survivorship issues, although exact surveillance strategies remain unclear.
Urological survivorship issues including ED, hypogonadism, and infertility are common among cancer survivors and result in significant morbidity. Due to the medical complexity of cancer survivorship, the population of adolescent and young adult survivors would benefit from a network of multidisciplinary survivorship experts to aid the transition into adulthood. Improved research efforts may help to clarify risk factors and to develop enhanced strategies for evaluation and treatment. Sukhu T, Ross S, Coward RM. Urological Survivorship Issues Among Adolescent Boys and Young Men Who Are Cancer Survivors. Sex Med Rev 2018;6:396-409.
泌尿系统的生存问题涵盖了青少年男孩和年轻男性在癌症治疗后可能被忽视的一个领域。癌症治疗的副作用可能包括成年后随后发生的勃起功能障碍（ED）、性腺功能减退和不育。
本综述的目的是关注癌症生存的青少年男孩和年轻男性在性和性腺功能障碍方面的范围和发生率，并讨论目前对评估和治疗的建议。
我们对评估年轻男性癌症生存者性腺功能减退、性功能障碍、ED 和不育的文献进行了综述。
有强有力的证据表明，完成癌症治疗后进入成年期的男孩面临着重大的生存问题。
总的来说，年轻的男性癌症幸存者比一般男性更有可能报告性功能障碍的症状。这些患者可能会由于诊断恶性肿瘤和随后的治疗所带来的生理和心理变化而发生 ED。盆腔放疗或化疗可导致原发性性腺功能减退，脑放疗或手术后可能出现垂体功能不足导致中枢性腺功能减退。放疗或化疗可直接损伤睾丸支持细胞和生殖上皮细胞导致不育。因此，男性癌症幸存者应该筛查这些重要的泌尿系统生存问题，尽管确切的监测策略仍不清楚。
泌尿系统的生存问题包括 ED、性腺功能减退和不育，在癌症幸存者中很常见，会导致严重的发病率。由于癌症生存的医学复杂性，青少年和年轻成年幸存者群体将受益于多学科生存专家网络，以帮助他们过渡到成年期。加强研究工作可能有助于阐明风险因素，并制定出用于评估和治疗的增强策略。
