MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, London, UK.
Department of Urology, University College London Hospitals NHS Foundation Trust, London, UK.
Andrology. 2020 Sep;8(5):988-995. doi: 10.1111/andr.12786. Epub 2020 Jun 22.
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.
Highlight the feasibility of maintaining post-operative fertility or normal semen parameters and endocrine function following PO.
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.
Eligible and relevant papers were assessed for data regarding fertility, semen parameters and endocrine function following PO for a small testicular mass (STM).
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.
对于随后被诊断为良性睾丸肿瘤的患者，根治性睾丸切除术由于对内源性睾酮、生育能力和身体形象的有害影响，代表了一种过度治疗。出于这些原因，在某些患者群体中应考虑部分睾丸切除术 (PO)。双侧肿瘤（同时或异时）或单侧睾丸肿瘤，肿瘤大小不超过睾丸体积的 30%，可考虑进行 PO。有证据表明，PO 对于小的睾丸肿块是有效的，具有极好的生存率和复发率。
强调 PO 后维持术后生育能力或正常精液参数和内分泌功能的可行性。
本综述的数据通过搜索 PubMed 数据库获得。论文必须为英文，并且专注于成年男性。
评估了适合且相关的论文，以获取关于 PO 治疗小睾丸肿块 (STM) 后生育能力、精液参数和内分泌功能的数据。
PO 后有可能同时保留生育能力和内分泌功能。尽管患者可能仍因伴发的管内生殖细胞肿瘤 (ITGCN) 而需要辅助放疗，导致生育能力下降，但内分泌功能仍得以保留。然而，为了生育能力的保留，可以推迟放疗并继续进行临床监测。
