Testis-sparing surgery: Experience in 13 patients with oncological and functional outcomes

  • Murat Keske University of Health Sciences, affiliated with Kayseri Training and Research Hospital
  • Abdullah Erdem Canda
  • Ali Fuat Atmaca
  • Ozer Ural Cakici
  • Muhammed Ersagun Arslan
  • Davut Kamaci
  • Mevlana Derya Balbay
Keywords: Partial orchiectomy, testis sparing surgery, testicular tumor

Abstract

Introduction: We present oncological and functional outcomes of patients who underwent testis-sparing surgery (TSS).

Methods: Overall, 13 patients were included. Mean patient age was 29.9±12.5 years. In five patients, TSS was performed for sequential bilateral testicular tumours. One patient underwent concurrent left radical orchiectomy and right TSS. In eight patients with normal contralateral testis, seven underwent left and one underwent right TSS.

Results: Mean pathological tumour size was 14.6±12.5 mm. Intraoperative frozen section evaluation of the mass was performed in eight patients that revealed benign lesions. No intraoperative tumour bed biopsies were taken in this patient group. Regarding the remaining five patients, intraoperative tumour bed biopsies were taken and testicular intraepithelial neoplasia (TIN) was reported in two (40%) patients; no local testicular radiotherapy was given postoperatively. Tumour pathology was malignant in all but one lesion, including Leydig cell tumour (n=1), seminoma(n=2), embryonal carcinoma (n=1), and adenomatoid tumour (n=1). During 47.2±22.5 months of followup, local recurrence was detected in one patient who underwent radical orchiectomy. No additional local recurrence or systemic metastasis was identified in other patients with malignant lesions. For patients with malignant tumours, of the three patients with a normal preoperative testosterone levels, testosterone level was normal in one patient (with no erectile dysfunction [ED]) and was decreased in two patients (with ED) following TSS. No ED was reported in the nine patients with benign lesions.

Conclusions: In carefully selected cases, TSS appears to be a safe, feasible procedure with adequate cancer control that could preserve sexual function.

Author Biography

Murat Keske, University of Health Sciences, affiliated with Kayseri Training and Research Hospital
Dept of urology
Published
2018-08-30
How to Cite
Keske, M., Canda, A. E., Atmaca, A. F., Cakici, O. U., Arslan, M. E., Kamaci, D., & Balbay, M. D. (2018). Testis-sparing surgery: Experience in 13 patients with oncological and functional outcomes. Canadian Urological Association Journal, 13(3). https://doi.org/10.5489/cuaj.5379
Section
Original Research