{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T20:15:09Z","timestamp":1771359309814,"version":"3.50.1"},"reference-count":37,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T00:00:00Z","timestamp":1718409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>We aimed to report sexual and reproductive outcomes following post-chemotherapy robot-assisted retroperitoneal unilateral lymph node dissection (PC-rRPLND) for non-seminomatous germ cell tumors (NSGCTs) at a high-volume cancer center. We collected records regarding sexual and reproductive outcomes of patients undergoing unilateral PC-rRPLND for stage II NSGCTs from January 2018 to November 2021. Preoperative and postoperative (at 12 months) ejaculatory function as well as erectile function, based on the International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Score (EHS), were assessed. Only patients with a pre-operative IIEF-5 of \u226522 and EHS of \u22653 were included in this analysis. Overall, 22 patients undergoing unilateral PC-rRPLND met the inclusion criteria. Of these, seven (31.8%) patients presented an andrological disorder of any type after PC-rRPLND. Specifically, retrograde ejaculation was present in three (13.6%) patients and hypospermia was present in one (4.5%) patient. Moreover, three (13.6%) patients yielded erectile dysfunction (IIEF-5 &lt; 22 and\/or EHS &lt; 3). Lastly, two (9.1%) succeeded in naturally conceiving a child after PC-rRPLND. Retrograde ejaculation is confirmed to be one of the most common complications of PC-rRPLND. Moreover, a non-negligible number of patients experience erectile dysfunction.<\/jats:p>","DOI":"10.3390\/cancers16122231","type":"journal-article","created":{"date-parts":[[2024,6,17]],"date-time":"2024-06-17T06:29:43Z","timestamp":1718605783000},"page":"2231","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Unilateral Post-Chemotherapy Robot-Assisted Retroperitoneal Lymph Node Dissection for Stage II Non-Seminomatous Germ Cell Tumors: Sexual and Reproductive Outcomes"],"prefix":"10.3390","volume":"16","author":[{"given":"Antonio","family":"Tufano","sequence":"first","affiliation":[{"name":"Uro-Gynecological Department, Istituto Nazionale Tumori di Napoli, IRCCS \u201cG. Pascale\u201d, Via M. Semmola, 80131 Naples, Italy"},{"name":"Department of Maternal-Infant and Urological Sciences, Policlinico Umberto I Hospital, \u201cSapienza\u201d Rome University, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8431-9830","authenticated-orcid":false,"given":"Simone","family":"Cilio","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6714-9315","authenticated-orcid":false,"given":"Gianluca","family":"Spena","sequence":"additional","affiliation":[{"name":"Uro-Gynecological Department, Istituto Nazionale Tumori di Napoli, IRCCS \u201cG. Pascale\u201d, Via M. Semmola, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3145-7313","authenticated-orcid":false,"given":"Alessandro","family":"Izzo","sequence":"additional","affiliation":[{"name":"Uro-Gynecological Department, Istituto Nazionale Tumori di Napoli, IRCCS \u201cG. Pascale\u201d, Via M. Semmola, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Castaldo","sequence":"additional","affiliation":[{"name":"Uro-Gynecological Department, Istituto Nazionale Tumori di Napoli, IRCCS \u201cG. Pascale\u201d, Via M. Semmola, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Grimaldi","sequence":"additional","affiliation":[{"name":"Uro-Gynecological Department, Istituto Nazionale Tumori di Napoli, IRCCS \u201cG. Pascale\u201d, Via M. Semmola, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raffaele","family":"Muscariello","sequence":"additional","affiliation":[{"name":"Uro-Gynecological Department, Istituto Nazionale Tumori di Napoli, IRCCS \u201cG. Pascale\u201d, Via M. Semmola, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dario","family":"Franzese","sequence":"additional","affiliation":[{"name":"Uro-Gynecological Department, Istituto Nazionale Tumori di Napoli, IRCCS \u201cG. Pascale\u201d, Via M. Semmola, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Quarto","sequence":"additional","affiliation":[{"name":"Uro-Gynecological Department, Istituto Nazionale Tumori di Napoli, IRCCS \u201cG. Pascale\u201d, Via M. Semmola, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7045-7725","authenticated-orcid":false,"given":"Riccardo","family":"Autorino","sequence":"additional","affiliation":[{"name":"Department of Urology, Rush University Medical Center, Chicago, IL 60612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Passaro","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sisto","family":"Perdon\u00e0","sequence":"additional","affiliation":[{"name":"Uro-Gynecological Department, Istituto Nazionale Tumori di Napoli, IRCCS \u201cG. Pascale\u201d, Via M. Semmola, 80131 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1007\/s11701-021-01252-1","article-title":"Robotic retroperitoneal lymph node dissection for primary and post-chemotherapy testis cancer","volume":"16","author":"Nason","year":"2022","journal-title":"J. Robot. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Busch, J., Magheli, A., Erber, B., Friedersdorff, F., Hoffmann, I., Kempkensteffen, C., Weikert, S., Miller, K., Schrader, M., and Hinz, S. (2012). Laparoscopic and open postchemotherapy retroperitoneal lymph node dissection in patients with advanced testicular cancer\u2014A single center analysis. BMC Urol., 12.","DOI":"10.1186\/1471-2490-12-15"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.aju.2012.01.001","article-title":"Laparoscopic retroperitoneal lymph node dissection for testicular cancer","volume":"10","author":"Hillelsohn","year":"2012","journal-title":"Arab. J. Urol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.urology.2005.07.022","article-title":"Robotic-assisted laparoscopic retroperitoneal lymph node dissection","volume":"67","author":"Davol","year":"2006","journal-title":"Urology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.ajur.2020.09.002","article-title":"Robot-assisted retroperitoneal lymphadenectomy: The state of art","volume":"8","author":"Rodrigues","year":"2021","journal-title":"Asian J. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"949","DOI":"10.21037\/tau.2020.02.09","article-title":"Primary and post-chemotherapy robotic retroperitoneal lymph node dissection for testicular cancer: A review","volume":"9","author":"Ray","year":"2020","journal-title":"Transl. Androl. Urol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Conduit, C., Hutchinson, A.D., Leonard, M., O\u2019Haire, S., Moody, M., Thomas, B., Sim, I., Hong, W., Ahmad, G., and Lawrentschuk, N. (2023). An exploration of testicular cancer survivors\u2019 experience of ejaculatory dysfunction following retroperitoneal lymph node dissection-a sub-study of the PREPARE clinical trial. J. Cancer Surviv.","DOI":"10.1007\/s11764-023-01489-9"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.eururo.2008.09.027","article-title":"Postchemotherapy retroperitoneal lymph node dissection in advanced testicular cancer: Radical or modified template resection","volume":"55","author":"Heidenreich","year":"2009","journal-title":"Eur. Urol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"579","DOI":"10.4103\/aja2021132","article-title":"A comprehensive evaluation of sexual and reproductive outcomes following robot-assisted retroperitoneal lymph node dissection for nonseminomatous germ cell tumor","volume":"24","author":"Mistretta","year":"2022","journal-title":"Asian J. Androl."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1177\/0310057X0203000516","article-title":"The ASA Physical Status Classification: Inter-observer consistency","volume":"30","author":"Mak","year":"2002","journal-title":"Anaesth. Intensive Care"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1016\/j.euo.2022.01.007","article-title":"New Landmarks Towards Reducing the Treatment Burden for Patients with a Postchemotherapy Residual Retroperitoneal Mass from Nonseminomatous Germ-cell Testicular Tumors","volume":"5","author":"Nicolai","year":"2022","journal-title":"Eur. Urol. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1177\/1756287209350315","article-title":"Management of the residual post-chemotherapy retroperitoneal mass in germ cell tumors","volume":"1","author":"Lavery","year":"2009","journal-title":"Ther. Adv. Urol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1634\/theoncologist.2013-0379","article-title":"Postchemotherapy surgery for germ cell tumors--what have we learned in 35 years?","volume":"19","author":"Riggs","year":"2014","journal-title":"The Oncologist"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e194","DOI":"10.1016\/j.clgc.2019.10.018","article-title":"Retroperitoneal Lymph Node Dissection as Primary Treatment for Men with Testicular Seminoma: Utilization and Survival Analysis Using the National Cancer Data Base, 2004\u20132014","volume":"18","author":"Tabakin","year":"2020","journal-title":"Clin. Genitourin. Cancer."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.euo.2019.08.002","article-title":"Surgical Complications in Postchemotherapy Retroperitoneal Lymph Node Dissection for Nonseminoma Germ Cell Tumour: A Population-based Study from the Swedish Norwegian Testicular Cancer Group","volume":"3","author":"Gerdtsson","year":"2020","journal-title":"Eur. Urol. Oncol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1016\/j.ajur.2023.05.002","article-title":"Unilateral post-chemotherapy robot-assisted retroperitoneal lymph node dissection in Stage II non-seminomatous germ cell tumor: A tertiary care experience","volume":"10","author":"Franzese","year":"2023","journal-title":"Asian J. Urol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1038\/s41443-022-00601-4","article-title":"Premature ejaculation among men with erectile dysfunction-findings from a real-life cross-sectional study","volume":"35","author":"Cilio","year":"2023","journal-title":"Int. J. Impot. Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1111\/andr.13506","article-title":"Unrecognised orgasmic phase disorders in men presenting with new-onset erectile dysfunction-Findings from a real-life, cross-sectional study","volume":"12","author":"Cilio","year":"2024","journal-title":"Andrology"},{"key":"ref_19","first-page":"209","article-title":"Andrological complications following retroperitoneal lymph node dissection for testicular cancer","volume":"69","author":"Crestani","year":"2017","journal-title":"Minerva Urol. Nefrol. Ital. J. Urol. Nephrol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/j.urolonc.2008.10.026","article-title":"Complications of open primary and post-chemotherapy retroperitoneal lymph node dissection for testicular cancer","volume":"28","author":"Subramanian","year":"2010","journal-title":"Urol. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2808","DOI":"10.1097\/JS9.0000000000000520","article-title":"The role of robotic retroperitoneal lymph node dissection in testicular cancer: A systematic review and meta-analysis","volume":"109","author":"Ge","year":"2023","journal-title":"Int. J. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"85","DOI":"10.4103\/1008-682X.149180","article-title":"Long-term recovery of normal sexual function in testicular cancer survivors","volume":"18","author":"Capogrosso","year":"2016","journal-title":"Asian J. Androl."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"217","DOI":"10.3857\/roj.2020.00332","article-title":"Erectile dysfunction and cancer: Current perspective","volume":"38","author":"Madan","year":"2020","journal-title":"Radiat. Oncol. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1111\/and.12462","article-title":"Sexual dysfunction in testicular cancer patients subjected to post-chemotherapy retroperitoneal lymph node dissection: A focus beyond ejaculation disorders","volume":"48","author":"Dimitropoulos","year":"2016","journal-title":"Andrologia"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e07479","DOI":"10.1016\/j.heliyon.2021.e07479","article-title":"Erectile dysfunction among testicular cancer survivors: A systematic review and meta-analysis","volume":"7","author":"Kerie","year":"2021","journal-title":"Heliyon"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.ucl.2019.04.010","article-title":"Preservation of Fertility in Testis Cancer Management","volume":"46","author":"Sineath","year":"2019","journal-title":"Urol. Clin. N. Am."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Maiolino, G., Fern\u00e1ndez-Pascual, E., Ochoa Arvizo, M.A., Vishwakarma, R., and Mart\u00ednez-Salamanca, J.I. (2023). Male Infertility and the Risk of Developing Testicular Cancer: A Critical Contemporary Literature Review. Med. Kaunas. Lith., 59.","DOI":"10.3390\/medicina59071305"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1016\/S0022-5347(01)61781-6","article-title":"Semen quality and reproductive hormones before and after orchiectomy in men with testicular cancer","volume":"161","author":"Petersen","year":"1999","journal-title":"J. Urol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1016\/S0022-5347(17)53996-8","article-title":"Ejaculation and fertility after extended retroperitoneal lymph node dissection for testicular cancer","volume":"127","author":"Narayan","year":"1982","journal-title":"J. Urol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Chavarriaga, J., Atenafu, E.G., Mousa, A., Langleben, C., Anson-Cartwright, L., Jewett, M., and Hamilton, R.J. (2024). Propensity-matched Analysis of Open Versus Robotic Primary Retroperitoneal Lymph Node Dissection for Clinical Stage II Testicular Cancer. Eur. Urol. Oncol.","DOI":"10.1016\/j.euo.2024.01.006"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.eururo.2016.05.017","article-title":"Safety and Early Oncologic Effectiveness of Primary Robotic Retroperitoneal Lymph Node Dissection for Nonseminomatous Germ Cell Testicular Cancer","volume":"71","author":"Pearce","year":"2017","journal-title":"Eur. Urol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1111\/bju.12804","article-title":"Robot-assisted retroperitoneal lymph node dissection: Technique and initial case series of 18 patients","volume":"115","author":"Cheney","year":"2015","journal-title":"BJU Int."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2146080","DOI":"10.1155\/2018\/2146080","article-title":"A Review of Outcomes and Technique for the Robotic-Assisted Laparoscopic Retroperitoneal Lymph Node Dissection for Testicular Cancer","volume":"2018","author":"Schwen","year":"2018","journal-title":"Adv. Urol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1016\/j.eururo.2012.09.036","article-title":"Postchemotherapy laparoscopic retroperitoneal lymph node dissection for low-volume, stage II, nonseminomatous germ cell tumor: Frst 100 patients","volume":"63","author":"Steiner","year":"2013","journal-title":"Eur. Urol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1505","DOI":"10.1007\/s00345-022-03974-9","article-title":"Minimally invasive retroperitoneal lymph node dissection for men with testis cancer: A retrospective cohort study of safety and feasibility","volume":"40","author":"Fankhauser","year":"2022","journal-title":"World J. Urol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1007\/s11255-012-0195-z","article-title":"Extraperitoneal laparoscopic retroperitoneal lymph node dissection after chemotherapy for nonseminomatous testicular germ-cell tumor: Surgical and oncological outcomes","volume":"44","author":"Arai","year":"2012","journal-title":"Int. Urol. Nephrol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1177\/03915603221146147","article-title":"Male infertility and urological tumors: Pathogenesis and therapeutical implications","volume":"90","author":"Gulino","year":"2023","journal-title":"Urologia"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/12\/2231\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:59:12Z","timestamp":1760108352000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/12\/2231"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,15]]},"references-count":37,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["cancers16122231"],"URL":"https:\/\/doi.org\/10.3390\/cancers16122231","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,15]]}}}