[Organ-sparing surgery for testicular tumors]

Abstract

Benign lesions of the testicles (stromal tumors, dermoid and epidermoid cysts as well as teratomas) are excised with the objective of preserving spermiogenesis and hormone production even though both testicles are present. If palpation, sonography and markers suggest a malignant tumor and the contralateral organ is affected by disease or has been ablated because of previous disease history, then enucleation resection is justified when the preoperative levels of plasma testosterone and LH are within the normal range. Postoperative irradiation of the unavoidable testicular intraepithelial neoplasia (TIN) with 20 Gy ensures the well-documented good results. If a child is desired, irradiation can be postponed with careful monitoring until pregnancy has ensued. Accurate indication and sophisticated technology result in a superiority of enucleation resection in comparison to non-surgical procedures (HIFU, chemotherapy, and irradiation for seminoma).