Introduction and current results of testis sparing surgery in Pécs
DOI: 10.2259/magyurol.2024.3.czetanyp.139
Authors:
Czétány Péter dr., Balló András dr., Szántó Árpád dr.
Pécsi Tudományegyetem, Klinikai Központ, Urológiai Klinika, Pécs (igazgató: Szántó Árpád dr.)
Summary
Introduction: The gold standard of primary treatment in testicular cancer is radical orchiectomy. Approximately 80% of small, non-palpable testicular lesions are of benign origin, in their case radical surgery means overtreatment, with serious consequences for this predominantly young patient population (e.g. reduced fertility, hypogonadism). Testis sparing surgery can offer an alternative, which can be performed even in the case of malignant tumors with imperative indications (synchronous tumor, solitary testis – metachronous tumor).
Patients and methods: Between 2018 and 2023, 13 patients underwent testis sparing surgery in our institute (Urology Clinic, University of Pécs Clinical Center). The indications – in accordance with the EAU and AUA recommendations – were the following: small, solitary lesion (
Results: In 8 cases the preliminary histological results (FSE) indicated benign lesion (e.g. sex cord-stromal tumors, adenomatoid tumors), thus we preserved the testis. In 5 cases, the FSE results suggested malignancy (seminoma, NSGCT): in 4 cases in the lack of imperative indication and in one further case based on the prior request of the patient orchiectomy was performed.
Discussion: The organ-preserving surgical approach brought a paradigm shift in the treatment of testicular tumors. In the case of benign tumors, unnecessary organ loss due to radical surgery and the associated complications can be avoided. For malignant tumors, it provides excellent, comparable oncological outcomes with superior functional results, emphasising the importance of careful patient selection, appropriate indication and surgical technique.