Organ‐sparing surgery does not lead to greater antisperm antibody levels than orchidectomy

Leonhartsberger, Nicolai; Gozzi, Christian; Akkad, Thomas; Springer-Stoehr, Brigitte; Bartsch, Georg; Steiner, Hannes

doi:10.1111/j.1464-410x.2007.06917.x

Cited by 19 publications

(6 citation statements)

References 29 publications

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“…In a recent study, the anti-sperm antibody level between orchidectomy and OSS was not statistically significant. 15 The present study also showed that patients with OSS have stable semen quality compared with their preoperative levels. Our data demonstrate that OSS can effectively preserve the functional integrity of the testis.…”

Section: Discussionsupporting

confidence: 53%

Experiences and outcomes of organ-sparing surgery for testicular tumour with benign tendency

Liu

Cheng

et al. 2015

CUAJ

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Introduction: We retrospectively investigated and summarized our experiences and the outcomes of organ-sparing surgery (OSS) for testicular tumour with benign tendency. Methods: From April 2000 to March 2012, 11 selected patients with testicular tumour underwent OSS. Preoperative and postoperative organ functional and oncologic indexes were analyzed and compared. Results: All operations were completed without conversion to radical orchiectomy. Intraoperative frozen section and routine postoperative pathology showed tumours with benign tendency. The normal appearance of the scrotum and functional integrity of the testis were preserved. Preoperative and postoperative serum sex hormone levels, international index of erectile function (IIEF-5) scores, and semen quality were not significantly different. Tumour recurrence or metastasis did not occur during follow-up. Conclusions: Our results showed the feasibility and safety of OSS to treat testicular tumour with benign tendency. With careful selection and rigorous follow-up, some testis tumor can be treated with OSS to maximally maintain normal appearance and function of the testis. The retrospective single-centre study and small sample size are main limitations. More evidence is needed to establish the large-scale application of OSS.

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Section: Discussionsupporting

confidence: 53%

Experiences and outcomes of organ-sparing surgery for testicular tumour with benign tendency

Liu

Cheng

et al. 2015

CUAJ

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“…While inguinal orchidectomy remains the standard for the diagnosis and staging of testicular neoplasms, we believe that removal of a testis for a benign lesion should be avoided. Organ-sparing surgery for benign lesions has been widely accepted and is widely advocated for the treatment of even malignant and stromal tumours [15,[29][30][31][32][33]. The use of frozen section examination is recommended, particularly in small tumours.…”

Section: Discussionmentioning

confidence: 99%

Increased incidence of Leydig cell tumours of the testis in the era of improved imaging techniques

Leonhartsberger¹,

Ramoner²,

Stoehr³

et al. 2011

BJU International

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Study Type – Diagnostic (exploratory cohort) Level of Evidence 2b What’s known on the subject? and What does the study add? Leydig cell tumours (LCTs) of the testis are rare tumours, accounting for 1–3% of all testicular neoplasms. Our data indicate that using scrotal ultrasound with high resolution imaging in routine checkups leads to an earlier detection of LCTs. Most patients underwent an organ‐sparing surgery and no androgen deprivation was observed. OBJECTIVE • To report an observed high frequency of Leydig cell tumours (LCTs) diagnosed at our centre. PATIENTS AND METHODS • Charts of all patients who underwent surgery for a testicular tumour between 1999 and 2008 at our department were searched and data from patients with LCT were collected. • Before surgery all patients underwent ultrasound and complete staging. In all but two patients with LCT an organ‐sparing surgery was performed. Surgery was performed under ultrasound or palpation guidance. • All patients underwent postoperative follow‐up. We retrospectively reviewed surgical technique, histology, epidemiology and outcome in all LCT patients. RESULTS • In the study period, 197 testicular tumours were surgically removed of which 29 were diagnosed as LCT (14.7% of 197; further study group) in 25 patients. Mean age of patients with LCT was 45 years (range 21–68 years). • Tumour size ranged from 1.2 to 80 mm (mean 10.23 mm). In two patients (8%) the lesion was palpable whereas incidental diagnosis was made in seven patients (28%). • In the remaining patients diagnosis was made by ultrasound performed for testicular pain (six patients, 24%) or during infertility or erectile dysfunction evaluation (10 patients, 40%). • Definitive histology reported no malignant histopathological features in all but one patient; this particular patient experienced tumour progression after 2 months and died from advanced disease 1 year later. All other patients are free of disease after a mean follow up of 56 months (range 7–93 months). • During this period one patient developed a second LCT on the contralateral side; another patient had a recurrence within the same testicle, but on the opposite pole. Both underwent a subsequent organ‐sparing tumour resection. CONCLUSION • The percentage of LCT (14.7% of all testicular tumours removed) was significantly higher than expected from the literature. One possible explanation for this phenomenon is the increasing use of better ultrasound technology and the subsequent increased detection of small nodules that have not been found in historical series. Use of ‘observation‐only’ for very small lesions detected at infertility clinics is under debate.

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“…In fact, it is clear that ASA-associated infertility is not absolute but depends on concentration, avidity, biological activity, and the antibodies' Ig class. It should also be stressed that Guazzieri et al (19) used immunofluorescence and immunoenzymatic assays, which can give numerous false-positive and falsenegative results and are therefore not considered as reference methods. Furthermore, the numerous studies of ASA demonstrate that the results achieved with radioimmunologic and immunoenzymatic methods are characterized by a low sensitivity and specificity, owing to the use of extractive antigens (21,22).…”

Section: Discussionmentioning

confidence: 98%

Testicular tumors as a possible cause of antisperm autoimmune response

Paoli

Gilio

Piroli

et al. 2009

Fertility and Sterility

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Organ‐sparing surgery does not lead to greater antisperm antibody levels than orchidectomy

Abstract: From these data, organ-sparing surgery does not lead to greater ASA levels than orchidectomy and patients are therefore at no greater risk of developing an autoimmune infertility.

Cited by 19 publications

References 29 publications

Experiences and outcomes of organ-sparing surgery for testicular tumour with benign tendency

Experiences and outcomes of organ-sparing surgery for testicular tumour with benign tendency

Increased incidence of Leydig cell tumours of the testis in the era of improved imaging techniques

Testicular tumors as a possible cause of antisperm autoimmune response

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