The implications of scrotal interference for the preservation of spermatogenesis in the management of testicular tumours.

Seminal analyses have been performed in 14 patients who have received radiation therapy following unilateral orchidectomy for testicular tumours. In patients receiving scrotal in addition to para-aortic and pelvic lymph node irradiation azoospermia occurred in 17 out 18 specimens examined, whereas in those patients not requiring scrotal irradiation, restoration of spermatogenesis occurred. The difference is a result of the increased dose of radiation received by the remaining testicle when the contralateral side of the scrotum is irradiated. Following scrotal aspiration, trans-scrotal biopsy or scrotal orchidectomy for testicular tumour, the scrotum becomes a possible site of recurrence and it should be electively irradiated. In order to give the patient the best chance of preserving fertility it is essential that scrotal interference in the management of testicular tumours must be avoided.