Department of Urology, Centre Hospitalier Universitaire, Université Catholique de Louvain, Namur, Belgium.
Department of Urology, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium.
Andrology. 2024 Sep;12(6):1347-1355. doi: 10.1111/andr.13577. Epub 2024 Jan 6.
Treatments against urogenital cancers frequently have fertility side-effects. The strategy to preserve fertility after oncologic treatments is still a matter of debate with a lack of evidence and international guidelines. The aim of this study is to investigate fertility preservation practices before urogenital cancer treatments and to compare national habits.
An online anonymous survey was submitted from January to June 2021 to six European urological societies. The 31-items questionnaire included questions about demography, habits of evaluation, and management of fertility preservation in case of urogenital cancer treatments.
Two hundred twenty-eight urologists from six urological societies in five different countries (Belgium, The Netherlands, Luxembourg, France, Finland) filled out the survey. Three quarter (74%; n = 166) usually propose a cryopreservation before orchidectomy. In case of oligo/azoo-spermia, the technique performed for the sperm extraction during orchidectomy varies among the sample: 70.5% (n = 160) of the responders do not perform a Testicular Sperm Extraction (TESE) nor a Percutaneous Epididymal Sperm Aspiration (PESA). The cryopreservation for prostate cancer treatments is never proposed in 48.17% (n = 105) of responders but conversely it is always proposed in 5.05% (n = 11). The cryopreservation before bladder cancer treatments is not commonly proposed (67.5%, n = 154).
Our study showed variable country specific tendencies in terms of fertility preservation in the period of treatment of urological cancers. These differences seem to be related to national guidelines recommendations. Standardization of international guidelines is urgently needed in the field of fertility for urological cancer patients.
针对泌尿生殖系统癌症的治疗方法常伴有生育副作用。在肿瘤治疗后保留生育力的策略仍然存在争议,缺乏证据和国际指南。本研究旨在调查泌尿生殖系统癌症治疗前的生育力保存实践,并比较各国的习惯。
2021 年 1 月至 6 月,我们向六个欧洲泌尿外科学会提交了一份在线匿名调查。该 31 项问卷包括有关人口统计学、生育力评估和保存习惯以及泌尿生殖系统癌症治疗中生育力保存管理的问题。
来自五个不同国家(比利时、荷兰、卢森堡、法国、芬兰)的六个泌尿外科学会的 228 名泌尿科医生填写了调查。四分之三(74%;n=166)通常在睾丸切除术前建议进行冷冻保存。在少精子症/无精子症的情况下,睾丸切除术期间进行的精子提取技术在样本中有所不同:70.5%(n=160)的应答者不进行睾丸精子提取(TESE)或经皮附睾精子抽吸术(PESA)。48.17%(n=105)的应答者在前列腺癌治疗时从不提出冷冻保存,但相反,5.05%(n=11)的应答者总是提出。膀胱癌治疗前的冷冻保存通常不被推荐(67.5%,n=154)。
我们的研究显示,在治疗泌尿生殖系统癌症期间,各国在生育力保护方面存在不同的趋势。这些差异似乎与国家指南的建议有关。在泌尿生殖系统癌症患者的生育领域,迫切需要标准化的国际指南。