ORIGINAL ARTICLES   

Minerva Urologica e Nefrologica 2005 March;57(1):47-52

Copyright © 2005 EDIZIONI MINERVA MEDICA

language: Italian

Unilateral testicular cancer: incidence and effects of a contralateral testiculopathy on the sperm output

Vicari E. ¹, Barone N. ², La Vignera S. ¹, Battiato C. ¹, Salemi M. ², Castiglione R. ², Giammusso B. ³

¹ Sezione di Endocrinologia Andrologia e Medicina Interna Dipartimento di Scienze Bio-Mediche Università degli Studi di Catania, Catania 2 Dottorato di Ricerca in Scienze Andrologiche Università degli Studi di Catania, Catania 3 Cattedra di Urologia Ospedale Vittorio Emanuele Università degli Studi di Catania, Catania

Aim. The aim of this paper was to evaluate the incidence of a non-tumoral, contralateral primitive testiculopathy and its relative influence on sperm quality of patients with unilateral testicular cancer.
Methods. Twenty-four patients (mean age 26 years, range 19-38) with testicular germ cell cancer (seminomas, SEM, in 10 cases; nonseminomas, NSEM, in the remaining 14 patients) after orchiectomy and before radiotherapy or chemotherapy underwent semen analysis, physical examination and scrotal ultrasound of their survivor testis.
Results. Patients with SEM had sperm concentration, total sperm count and forward motility significantly higher than those found in patients with NSEM. Altogether, 5 out of 24 patients (2 SEM; 3 NSEM) (20.8%) showed azoospermia; 10 patients (41.7%) (3 SEM; 7 NSEM) had oligo-, astheno- and/or terato-zoospermia (OAT). The remaining 9 patients (37.5%) (5 SEM; 4 NSEM) showed normal sperm parameters. The testicular volume of the left over testis was reduced (<12 ml) in 4 out of 5 (80%) azoospermic patients, in 7 out of 10 patients (70%) of OAT patients, but in no patient (0%) with normozoospermia. A testicular biopsy performed on the survivor testis of 5 patients with azoospermia (4 of them had a reduced testicular volume) confirmed the primitive testiculopathy, showing a histological pattern of Sertoli cell syndrome only in 4 of them (80%) and maturation arrest in the other case (20%).
Conclusion. Less (OAT) or more severe (azoospermia) sperm output impairment in patients with unilateral testicular cancer is associated with a coincidental, contralateral to unilateral testicular cancer, primitive testiculopathy expressed as reduced testicular volume and impairment spermatogenesis at the testicular biopsy.