INTRODUCTION: Males who present with a palpable testis nodule are likely to have malignant germ cell tumor in >90% of cases. Therefore radical orchiectomy remains the standard of care for intratesticular tumors. However, due to the recent developments of high-frequency probes in ultrasonography, the incidence of detecting a small non-palpable testis tumor is higher and higher. These lesions are thought to be benign in more than 60-80% of cases, thus a radical orchiectomy should be considered an overtreatment. In addition to that, radical orchiectomy might cause infertility, psychological issues and endocrine disorders, hence an organ-sparing procedure in such cases should be pursued. EVIDENCE ACQUISITION: Only fourteen reliable retrospective studies met the inclusion criteria. No prospective randomized trials have appeared in Medline database. EVIDENCE SYNTHESIS: This review of the current literature has confirmed the safety and efficacy of testicularsparing surgery in selected patients: 1) monorchid patients; 2) bilateral testis masses; 3) normal patients with a small, non-palpable masses detected with US, as long as the dimension of the lesion is up to 3 cm and not greater that 30% of the total volume of the organ. CONCLUSIONS: According to the literature, testis sparing surgery is a safe and feasible procedure for patients presenting a benign small testis mass. The enthusiasm found in the literature should however be tempered as the small number of patients reported in the studies coupled with the absence of a prospective trial represent important limits that need to be overtaken. Therefore more robust and well-designed studies are needed.
Testis-sparing surgery for testicular masses: Current perspectives / La Rocca, R. L.; Capece, M.; Spirito, L.; Cumberbatch, M. K.; Creta, M.; Altieri, V.; Franco, G.; Albisinni, S.; Mirone, V.; Esperto, F.. - In: MINERVA UROLOGICA E NEFROLOGICA. - ISSN 0393-2249. - 71:4(2019), pp. 359-364.
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|Titolo:||Testis-sparing surgery for testicular masses: Current perspectives|
|Data di pubblicazione:||2019|
|Citazione:||Testis-sparing surgery for testicular masses: Current perspectives / La Rocca, R. L.; Capece, M.; Spirito, L.; Cumberbatch, M. K.; Creta, M.; Altieri, V.; Franco, G.; Albisinni, S.; Mirone, V.; Esperto, F.. - In: MINERVA UROLOGICA E NEFROLOGICA. - ISSN 0393-2249. - 71:4(2019), pp. 359-364.|
|Appartiene alla tipologia:||01a Articolo in rivista|