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What is it about?
The study aimed to assess attitudes, practices, and barriers towards fertility assessment and preservation in patients undergoing radical inguinal orchidectomy (RIO) for testicular cancer. An international online survey was developed and distributed through social media and national urological societies. Out of 393 respondents, 57.1% routinely offered semen cryopreservation prior to RIO, and 36.0% performed pre-operative semen analysis. The study found that a significant proportion of international urologists do not offer preoperative fertility assessment and preservation, and that surgery is performed in an expedited fashion within 1 week in the majority of patients. Urologists perceive there to be a lack of access and availability to fertility services, and delay to RIO to allow for fertility considerations is often not acceptable.
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Why is it important?
This research is important as it provides an international assessment of urological practice regarding fertility assessment and preservation in patients undergoing radical inguinal orchidectomy (RIO) for testicular cancer. It represents the best available evidence to inform future improvements in fertility practice in this cohort of patients. Despite international guideline recommendations, only 57.1% of urologists routinely offer semen cryopreservation prior to RIO, and the study identifies barriers to this practice. Improving clinical training and pathways, as well as evidence-based guideline recommendations, are necessary to address these concerns and improve fertility outcomes for testicular cancer patients. Key Takeaways: 1. 57.1% of urologists routinely offer semen cryopreservation prior to RIO. 2. 36.0% of urologists routinely perform pre-operative semen analysis, and 22.1% routinely perform pre-operative testicular serum hormone profile. 3. A significant proportion of international urologists do not offer preoperative fertility assessment and preservation in men undergoing RIO for testicular cancer. 4. Improvements in fertility outcomes for testicular cancer patients will require addressing the identified barriers through improved clinical training and pathways, as well as evidence-based guideline recommendations.
Perspectives
This article looks at clinicians attitudes, practices and barriers towards fertility assessment and preservation in testicular cancer patients from an international perspective. We hope clinicians worldwide find this article enlightening but also thought-provoking in how they personally manage these patients and at very least if they don't already, look at the merits of pre-operative fertility assessments to guide future fertility management.
Anthony Emmanuel
Guy's & St Thomas' NHS Foundation Trust
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Read the Original
This page is a summary of: An international survey of contemporary practices towards fertility assessment and preservation in patients undergoing radical inguinal orchidectomy for testicular cancer, BJUI Compass, April 2024, Wiley,
DOI: 10.1002/bco2.356.
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