Testicular sperm extraction in a patient with ejaculatory dysfunction after combined androgen blockade therapy for prostate cancer

Abstract

Introduction Prostate cancer is the most prevalent urological cancer for older men. However, there is still a possibility that a few prostate cancer patients may still wish to have children. Case presentation A 49‐year‐old male was diagnosed with low‐risk prostate cancer. Combined anti‐androgen blockade therapy was performed for 8 months prior to radiation therapy. However, he suffered from ejaculatory dysfunction and wished to conceive with his partner. Hormonal therapy was discontinued and he was referred to our clinic for sperm preservation. His ejaculatory function did not recover after 4 months discontinuation of hormonal therapy, subsequently micro‐testicular sperm extraction for sperm preservation was successfully performed. Conclusion Sperm preservation in patients with prostate cancer is unusual but it should be considered if the patient’s fertility is an issue.

Editorial Comment to Sperm cryopreservation before definitive therapy for early‐stage prostate cancer: A single institution experience

“…A case of intra‐testicular sperm extraction after initiation of androgen deprivation therapy for prostate cancer has been reported 4 . We have also experienced a case in which a patient who wished to have a baby after total prostatectomy underwent intra‐testicular sperm extraction for in vitro fertilization.…”

Sperm cryopreservation before definitive therapy for early‐stage prostate cancer: A single institution experience

“…Although there is no question that the sperm cryopreservation is a gold standard for male‐fertility preservation, sperm preservation by testicular sperm extraction (TESE) is also useful. Especially, for the patients with ejaculatory dysfunction, for example, the patients received prostatectomy, radiation therapy for the prostate, 6 or androgen ablation therapy, 6 , 7 TESE might be recommended instead of the sperm cryopreservation.…”