A comparative study of changes in sperm parameters before and after testicular tumor surgery
Iwai, H1; Tai, T1; Nagai, K1
1: Toho University Omori Medical Center, Japan
Objective: A testicular tumor may be found in male infertility outpatients who have been examined for oligospermia or azoospermia. It has been known that testicular tumor patients have complicated testicular function disorder. We have experienced several cases in which semen data did not improve after removal of a testicular tumor. In this study, we examined changes in semen data and endocrine data of patients with a testicular tumor before and after excisional surgery.
Material and method: We examined 10 cases (22 y.o. to 47 y.o, ave. 34.27 y.o.) in which semen data could be confirmed before and after excisional surgery among patients who underwent inguinal orchiectomy with testicular tumor in the Urology Department of Toho University Omori Hospital from 2010 to 2015.
Results: Results of pathological examinations were 7 cases of seminoma, 1 case of seminoma + embryonal carcinoma, and 2 cases of Leidig tumor. Of these 10 cases, azoospermia was found in 4 cases, and seminal examination after surgery showed that azoospermia did not improve in any of the cases. After surgery, semen volume increased in all cases, but sperm concentration and sperm motility rate decreased in nine cases. Average sperm parameters before and after surgery, respectively, were as follows: semen volume (2.29 ml vs. 2.47 ml), sperm concentration (21.75 x 106/ml vs. 11.28 x 106/ml), sperm motility rate (36.79% vs. 25.63%), total motor sperm count (24.42 x 106 vs. 12.06 x 106). The average serum hormone levels were not significantly different, but they showed a decreasing trend.
Conclusion: There is no clear criterion for timing to freeze sperm in testicular tumor. In this study, sperm count can be worse after orchiectomy, so it is useful to freeze sperm before surgery.
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