A preliminary report: postoperative fertility assessment in nerve-sparing RPLND patients.

Nerve-sparing RPLND is a procedure suited to patients with clinical stage I nonseminoma. Additionally, nerve-sparing techniques are applicable to patients with higher stage disease. Although ejaculation is reliably preserved with nerve-sparing techniques, the question of these patients' fertility has remained. Fertility was assessed in these patients by two techniques: laboratory analysis of semen and a post-RPLND questionnaire. Semen analyses and DNA histograms suggested fertility in > 70%; in addition, 43 of 53 (81%) patients who have tried to father children post RPLND have been successful. Nerve-sparing RPLND appears to be able to preserve fertility potential in these patients.