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We conducted a systematic search of Medline (Ovid), Embase, Cochrane CENTRAL, CINAHL, Scopus, Web of Science, ClinicalTrials.gov, and the WHO\/ICTRP from inception to November 20, 2020. Manuscripts and published abstracts were included if they involved testis\u2010sparing surgery (TSS) and contained data on any outcomes related to fertility, hormonal parameters, or oncological control, or if they evaluated surgical technique.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our initial search yielded 3,370 manuscripts, with 269 of these screened for full\u2010text eligibility. After our exclusion criteria were applied, 32 studies were included in the final analysis. Oncological outcomes were obtained from 12 studies (average follow\u2010up 57.8\u00a0months), functional data from 26 studies (average follow\u2010up 49.6\u00a0months), fertility information from 10 studies (average follow\u2010up 55.8\u00a0months), and data on nonpalpable tumors from 11 studies (average follow\u2010up 32.1\u00a0months). Oncological control appears to be excellent in studies that reported these outcomes. Presence of germ cell neoplasia in situ was controlled with adjuvant radiation in nearly all cases. Functional outcomes are also promising, as development of primary and compensated hypogonadism was rare. Semen parameters are poor preoperatively among men with benign and malignant testis tumors, with occasional decline after TSS. Frozen section analysis at the time of surgery appears to be very reliable, and the majority of nonpalpable tumors appear to be benign.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>TSS is a safe and efficacious technique with regards to oncological control and postoperative hormonal function based on retrospective, noncontrolled studies. TSS avoids unnecessary removal of benign testicular tissue, and should be given serious consideration in cases of nonpalpable, small tumors under 2\u00a0cm. In cases of malignancy, TSS can safely avoid anorchia in men with bilateral tumors and in men with solitary testicles. The use of the operating microscope, while theoretically promising, does not necessarily lead to better outcomes, however data are limited.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bco2.77","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T09:45:16Z","timestamp":1614073516000},"page":"306-321","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Outcomes of organ\u2010sparing surgery for adult testicular tumors: A systematic review of the literature"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9176-4334","authenticated-orcid":false,"given":"Jesse","family":"Ory","sequence":"first","affiliation":[{"name":"Department of Urology Miller School of Medicine University of Miami  Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udi","family":"Blankstein","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Urology University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel C.","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Urology Miller School of Medicine University of Miami  Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya A.","family":"Sathe","sequence":"additional","affiliation":[{"name":"College of Medicine University of Tennessee Health Science Center  Memphis TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua T.","family":"White","sequence":"additional","affiliation":[{"name":"Department of Urology Dalhousie University  Halifax NS Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0400-2647","authenticated-orcid":false,"given":"Carlos","family":"Delgado","sequence":"additional","affiliation":[{"name":"School of Medicine and Health Science Tecnologico de Monterrey  Monterrey Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6744-3517","authenticated-orcid":false,"given":"John","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Department of Health Informatics Miller School of Medicine University of Miami Calder Memorial Library  Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"Jarvi","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Urology University of Toronto  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjith","family":"Ramasamy","sequence":"additional","affiliation":[{"name":"Department of Urology Miller School of Medicine University of Miami  Miami FL USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0302-2838(03)00263-X"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.3.941"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.08.004"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000092066.01699.90"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-015-4059-7"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2009.12.012"},{"key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1097\/JU.0000000000001337","article-title":"Real\u2010world application of pre\u2010orchiectomy miR\u2010371a\u20103p test in testicular germ cell tumor management","volume":"205","author":"Badia RR","year":"2021","journal-title":"J Urol"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000000318"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.5489\/cuaj.815"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2011.05.038"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40477-015-0171-4"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2005.05569.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2016.01.021"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.5195\/jmla.2020.834"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2010.01.014"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/andr.12786"},{"key":"e_1_2_8_18_1","unstructured":"EndNote. 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