{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T04:09:36Z","timestamp":1788754176890,"version":"build-2803163510"},"reference-count":116,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,3,31]],"date-time":"2024-03-31T00:00:00Z","timestamp":1711843200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>The incidence of testicular cancer (TC) has been rapidly increasing over the past years. Diagnosis and early treatment have shown good oncological control, guaranteeing the patient different treatment approaches according to histology and tumor stage. Currently, physicians usually prioritize oncological outcomes over sexual outcomes and quality of life, considering as a first aim the overall survival of the patients; however, differently from other neoplasms, quality of life is still strongly affected among TC patients, and sexual outcomes are frequently compromised after each TC treatment. Several studies have suggested that each treatment approach may be associated with sexual dysfunctions, including erectile dysfunction, ejaculatory disorders, fertility issues, and hormonal changes. Since testicular cancer patients are more frequently young men, the subject of this work is substantial and should be analyzed in detail to help specialists in the management of this disease. The aim of the current narrative review is to generally describe every treatment for TC, including surgery, chemotherapy, radiotherapy, and retroperitoneal lymph node dissection, and to establish which sexual dysfunction may be specifically associated with each therapy.<\/jats:p>","DOI":"10.3390\/medicina60040586","type":"journal-article","created":{"date-parts":[[2024,3,31]],"date-time":"2024-03-31T13:44:52Z","timestamp":1711892692000},"page":"586","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Testicular Cancer Treatments and Sexuality: A Narrative Review"],"prefix":"10.3390","volume":"60","author":[{"given":"Massimiliano","family":"Raffo","sequence":"first","affiliation":[{"name":"Department of Urology, Spedali Civili Brescia, 25123 Brescia, Italy"},{"name":"Division of Experimental Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, 20132 Milan, Italy"},{"name":"Faculty of Medicine, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Di Naro","sequence":"additional","affiliation":[{"name":"Department of Urology, Spedali Civili Brescia, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2036-0356","authenticated-orcid":false,"given":"Luigi","family":"Napolitano","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8470-1995","authenticated-orcid":false,"given":"Achille","family":"Aveta","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9621-3059","authenticated-orcid":false,"given":"Savio Domenico","family":"Pandolfo","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9706-8516","authenticated-orcid":false,"given":"Celeste","family":"Manfredi","sequence":"additional","affiliation":[{"name":"Urology Unit, Department of Woman, Child and General and Specialized Surgery, Luigi Vanvitelli University, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0113-9920","authenticated-orcid":false,"given":"Chiara","family":"Lonati","sequence":"additional","affiliation":[{"name":"Department of Urology, Spedali Civili Brescia, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazareno Roberto","family":"Suardi","sequence":"additional","affiliation":[{"name":"Department of Urology, Spedali Civili Brescia, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,31]]},"reference":[{"key":"ref_1","first-page":"329","article-title":"Cardiovascular and Cancer Death Rates in the Brazilian Population Aged 35 to 74 Years, 1996\u20132017","volume":"117","author":"Favarato","year":"2021","journal-title":"Arq. Bras. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"196","DOI":"10.3389\/fendo.2019.00196","article-title":"Long-Term Follow Up of the Erectile Function of Testicular Cancer Survivors","volume":"10","author":"Pallotti","year":"2019","journal-title":"Front. Endocrinol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/s11912-023-01375-8","article-title":"Cardiovascular Risks in Testicular Cancer: Assessment, Prevention, and Treatment","volume":"25","author":"Clasen","year":"2023","journal-title":"Curr. Oncol. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1016\/j.eururo.2008.02.039","article-title":"Predicting the probability of deferred radical treatment for localised prostate cancer managed by active surveillance","volume":"54","author":"Norman","year":"2008","journal-title":"Eur. Urol."},{"key":"ref_5","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_6","first-page":"69","article-title":"Impact of cancer therapy on post-treatment ejaculation disorder and sexual life in testicular cancer survivors","volume":"28","author":"Koyama","year":"2021","journal-title":"Int. J. Urol. Off. J. Jpn. Urol. Assoc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1046\/j.1464-410X.1997.00027.x","article-title":"Sexual functioning in testosterone-supplemented patients treated for bilateral testicular cancer","volume":"79","author":"Sleijfer","year":"1997","journal-title":"Br. J. Urol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Yazici, S., Del Biondo, D., Napodano, G., Grillo, M., Calace, F.P., Prezioso, D., Crocetto, F., and Barone, B. (2023). Risk Factors for Testicular Cancer: Environment, Genes and Infections\u2014Is It All?. Medicina, 59.","DOI":"10.3390\/medicina59040724"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e12390","DOI":"10.1097\/MD.0000000000012390","article-title":"Recent global trends in testicular cancer incidence and mortality","volume":"97","author":"Park","year":"2018","journal-title":"Medicine"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1411","DOI":"10.1016\/S0022-5347(01)64228-9","article-title":"Sexual functioning after multimodality treatment for disseminated nonseminomatous testicular germ cell tumor","volume":"158","author":"Sleijfer","year":"1997","journal-title":"J. Urol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1093\/jjco\/hyn009","article-title":"Survival of metastatic germ cell cancer patients assessed by international germ cell consensus classification in Japan","volume":"38","author":"Shintaku","year":"2008","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_12","first-page":"923","article-title":"Identification of a subgroup with worse prognosis among patients with poor-risk testicular germ cell tumor","volume":"22","author":"Kojima","year":"2015","journal-title":"Int. J. Urol. Off. J. Jpn. Urol. Assoc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1007\/s00345-023-04381-4","article-title":"Testicular self-examination for early detection of testicular cancer","volume":"41","author":"Chong","year":"2023","journal-title":"World J. Urol."},{"key":"ref_14","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. Medicina, 59.","DOI":"10.3390\/medicina59071305"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1002\/pon.5700","article-title":"Quality of life, anxiety and depression patient-reported outcome measures in testicular cancer: A systematic review","volume":"30","author":"Dincer","year":"2021","journal-title":"Psychooncology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"113","DOI":"10.3389\/fendo.2019.00113","article-title":"Psychosocial Issues in Long-Term Survivors of Testicular Cancer","volume":"10","author":"Schepisi","year":"2019","journal-title":"Front. Endocrinol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.ucl.2021.07.001","article-title":"Oncosexology","volume":"48","author":"Salter","year":"2021","journal-title":"Urol. Clin. N. Am."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3803","DOI":"10.2147\/CMAR.S198039","article-title":"An Updated Systematic Review of Quantitative Studies Assessing Anxiety, Depression, Fear of Cancer Recurrence or Psychological Distress in Testicular Cancer Survivors","volume":"13","author":"Rincones","year":"2021","journal-title":"Cancer Manag. Res."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Wettergren, L., Ljungman, L., Micaux Obol, C., Eriksson, L.E., and Lampic, C. (2020). Sexual dysfunction and fertility-related distress in young adults with cancer over 5\u2009years following diagnosis: Study protocol of the Fex-Can Cohort study. BMC Cancer, 20.","DOI":"10.1186\/s12885-020-07175-8"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.euf.2018.11.007","article-title":"Sexual Function and Quality of Life in a National Cohort of Survivors of Bilateral Testicular Cancer","volume":"6","author":"Bandak","year":"2020","journal-title":"Eur. Urol. Focus."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.mcna.2017.10.003","article-title":"Testicular Cancer: Epidemiology, Diagnosis, and Management","volume":"102","author":"Smith","year":"2018","journal-title":"Med. Clin. N. Am."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.ucl.2015.05.003","article-title":"Infertility with Testicular Cancer","volume":"42","author":"Ostrowski","year":"2015","journal-title":"Urol. Clin. N. Am."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1002\/cncr.31862","article-title":"Fertility counseling before cancer treatment and subsequent reproductive concerns among female adolescent and young adult cancer survivors","volume":"125","author":"Young","year":"2019","journal-title":"Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J. Chronic Dis."},{"key":"ref_25","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_26","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/S0302-2838(02)00274-9","article-title":"Gonadal function and fertility in patients with bilateral testicular germ cell malignancy","volume":"42","author":"Jacobsen","year":"2002","journal-title":"Eur. Urol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"92.e1","DOI":"10.1016\/j.urolonc.2017.11.002","article-title":"Fertility preservation for men with testicular cancer: Is. sperm cryopreservation cost effective in the era of assisted reproductive technology?","volume":"36","author":"Gilbert","year":"2018","journal-title":"Urol. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1200\/JCO.2002.20.6.1537","article-title":"Effect of graded testicular doses of radiotherapy in patients treated for carcinoma-in-situ in the testis","volume":"20","author":"Petersen","year":"2002","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.eururo.2010.03.041","article-title":"Paternity and testicular function among testicular cancer survivors treated with two to four cycles of cisplatin-based chemotherapy","volume":"58","author":"Klepp","year":"2010","journal-title":"Eur. Urol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1038\/bjc.2012.471","article-title":"Sperm counts and endocrinological markers of spermatogenesis in long-term survivors of testicular cancer","volume":"107","author":"Klepp","year":"2012","journal-title":"Br. J. Cancer"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Garc\u00eda Rojo, E., Giannarini, G., Garc\u00eda G\u00f3mez, B., Feltes Ochoa, J.A., Guerrero Ramos, F., Alonso Isa, M., Brime Menendez, R., Saenz Calzada, D.M., Justo Quintas, J., and Fraile, A. (2023). Organ-Sparing Surgery for Testicular Germ Cell Tumors: A Current Perspective. Medicina, 59.","DOI":"10.3390\/medicina59071249"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1159\/000531645","article-title":"A Retrospective Analysis of 83 Patients with Testicular Mass Who Underwent Testis-Sparing Surgery: The Eurasian Uro-oncology Association Multicenter Study","volume":"107","author":"Keske","year":"2023","journal-title":"Urol. Int."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e170","DOI":"10.1016\/j.clgc.2023.11.005","article-title":"Epidemiology, Management, and Survival Outcomes of Germ Cell Cancer in Southern Portugal: A Population-Based Study (2008\u20132012)","volume":"22","author":"Brito","year":"2024","journal-title":"Clin. Genitourin. Cancer"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"4448","DOI":"10.1200\/JCO.2002.01.038","article-title":"Prognostic factors for relapse in stage I seminoma managed by surveillance: A pooled analysis","volume":"20","author":"Warde","year":"2002","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1016\/j.eururo.2014.07.001","article-title":"A nationwide cohort study of stage I seminoma patients followed on a surveillance program","volume":"66","author":"Mortensen","year":"2014","journal-title":"Eur. Urol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e070499","DOI":"10.1136\/bmj-2022-070499","article-title":"Advances in diagnosis and treatment of testicular cancer","volume":"379","author":"Chovanec","year":"2022","journal-title":"BMJ"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1016\/S0360-3016(02)02849-3","article-title":"Treatment outcome, body image, and sexual functioning after orchiectomy and radiotherapy for Stage I-II testicular seminoma","volume":"53","author":"Incrocci","year":"2002","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"66","DOI":"10.3322\/canjclin.34.2.66","article-title":"Sexual rehabilitation of urologic cancer patients: A practical approach","volume":"34","author":"Schover","year":"1984","journal-title":"CA Cancer J. Clin."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1590\/s1677-5538.ibju.2023.9901","article-title":"Changes in male sexuality after urologic cancer: A narrative review","volume":"49","author":"Barros","year":"2023","journal-title":"Int. Braz. J. Urol. Off. J. Braz. Soc. Urol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1046\/j.1464-4096.2001.02392.x","article-title":"Testicular implants and patient satisfaction: A questionnaire-based study of men after orchidectomy for testicular cancer","volume":"88","author":"Adshead","year":"2001","journal-title":"BJU Int."},{"key":"ref_41","first-page":"1526","article-title":"Association of financial toxicity with quality of life in testicular cancer survivors","volume":"29","author":"Nezu","year":"2022","journal-title":"Int. J. Urol. Off. J. Jpn. Urol. Assoc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.ecl.2021.11.014","article-title":"Testicular Dysfunction Among Cancer Survivors","volume":"51","author":"Elenkov","year":"2022","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1002\/(SICI)1097-0142(19970801)80:3<454::AID-CNCR13>3.0.CO;2-W","article-title":"Sexual functioning after treatment for testicular cancer: Comparison of treatment modalities","volume":"80","author":"Hoekstra","year":"1997","journal-title":"Cancer"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/00005392-199501000-00030","article-title":"The role of retroperitoneal lymphadenectomy in clinical stage B testis cancer: The Indiana University experience (1965 to 1989)","volume":"153","author":"Donohue","year":"1995","journal-title":"J. Urol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1097\/01.ju.0000101513.64777.f2","article-title":"A Simple Model for Predicting Nodal Metastasis in Patients With Clinical Stage I Nonseminomatous Germ Cell Testicular Tumors Undergoing Retroperitoneal Lymph Node Dissection Only","volume":"171","author":"Nicolai","year":"2004","journal-title":"J. Urol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1097\/01.ju.0000165342.85300.14","article-title":"Treatment of erectile dysfunction following therapy for clinically localized prostate cancer: Patient reported use and outcomes from the Surveillance, Epidemiology, and End Results Prostate Cancer Outcomes Study","volume":"174","author":"Stephenson","year":"2005","journal-title":"J. Urol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1097\/SPC.0000000000000692","article-title":"Cancer survivor late-effects, chronic health problems after cancer treatment: What\u2019s the evidence from population and registry data and where are the gaps?","volume":"18","author":"Faithfull","year":"2024","journal-title":"Curr. Opin. Support. Palliat. Care"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1111\/j.1464-410X.2006.06188.x","article-title":"Treating stage I nonseminomatous germ cell tumours with a single cycle of chemotherapy","volume":"98","author":"Gilbert","year":"2006","journal-title":"BJU Int."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1200\/JCO.2009.26.4655","article-title":"Randomized Trial of Carboplatin Versus Radiotherapy for Stage I Seminoma: Mature Results on Relapse and Contralateral Testis Cancer Rates in MRC TE19\/EORTC 30982 Study (ISRCTN27163214)","volume":"29","author":"Oliver","year":"2011","journal-title":"J. Clin. Oncol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2122","DOI":"10.1200\/JCO.2008.18.8953","article-title":"Risk-adapted treatment in clinical stage I nonseminomatous germ cell testicular cancer: The SWENOTECA management program","volume":"27","author":"Tandstad","year":"2009","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1093\/annonc\/mdu518","article-title":"Long-term outcome of patients with clinical stage I high-risk nonseminomatous germ-cell tumors 15 years after one adjuvant cycle of bleomycin, etoposide, and cisplatin chemotherapy","volume":"26","author":"Vidal","year":"2015","journal-title":"Ann. Oncol. Off. J. Eur. Soc. Med. Oncol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.juro.2007.08.172","article-title":"Long-term followup results of 1 cycle of adjuvant bleomycin, etoposide and cisplatin chemotherapy for high risk clinical stage I nonseminomatous germ cell tumors of the testis","volume":"179","author":"Westermann","year":"2008","journal-title":"J. Urol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1056\/NEJM198712033172303","article-title":"Immediate adjuvant chemotherapy versus observation with treatment at relapse in pathological stage II testicular cancer","volume":"317","author":"Williams","year":"1987","journal-title":"N. Engl. J. Med."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1093\/annonc\/mdy217","article-title":"ESMO Consensus Conference on testicular germ cell cancer: Diagnosis, treatment and follow-up","volume":"29","author":"Honecker","year":"2018","journal-title":"Ann. Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/j.eururo.2007.12.024","article-title":"European Consensus Conference on Diagnosis and Treatment of Germ Cell Cancer: A Report of the Second Meeting of the European Germ Cell Cancer Consensus group (EGCCCG): Part, I","volume":"53","author":"Krege","year":"2008","journal-title":"Eur. Urol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/0090-4295(86)90367-5","article-title":"Sexual and marital relationships after radiotherapy for seminoma","volume":"27","author":"Schover","year":"1986","journal-title":"Urology"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2399","DOI":"10.1002\/1097-0142(19891201)64:11<2399::AID-CNCR2820641134>3.0.CO;2-P","article-title":"Psychosocial factors, curative therapies, and behavioral outcomes. A comparison of testis cancer survivors and a control group of healthy men","volume":"64","author":"Rieker","year":"1989","journal-title":"Cancer"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"4180","DOI":"10.1210\/jc.2009-0337","article-title":"Hypogonadism Risk in Men Treated for Childhood Cancer","volume":"94","author":"Romerius","year":"2009","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1038\/sj.bmt.1703777","article-title":"Germ cell damage and Leydig cell insufficiency in recipients of nonmyeloablative transplantation for haematological malignancies","volume":"31","author":"Kyriacou","year":"2003","journal-title":"Bone Marrow Transpl."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"151.e11","DOI":"10.1016\/j.urolonc.2022.11.004","article-title":"Impact of testicular cancer stage on semen parameters in patients before orchiectomy","volume":"41","author":"Badia","year":"2023","journal-title":"Urol. Oncol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1007\/s11764-019-00841-2","article-title":"Men\u2019s experiences of surviving testicular cancer: An integrated literature review","volume":"14","author":"Alexis","year":"2020","journal-title":"J. Cancer Surviv. Res. Pract."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"199","DOI":"10.3322\/canjclin.40.4.199","article-title":"Effects of cancer chemotherapy on gonadal function and reproductive capacity","volume":"40","author":"Averette","year":"1990","journal-title":"CA Cancer J. Clin."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1007\/s10147-019-01572-1","article-title":"Correction to: Fertility in testicular cancer patients: A single-centre study in Turkey","volume":"25","author":"Arikan","year":"2020","journal-title":"Int. J. Clin. Oncol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.fertnstert.2013.05.018","article-title":"Impact of chemotherapy and radiotherapy for testicular germ cell tumors on spermatogenesis and sperm DNA: A multicenter prospective study from the CECOS network","volume":"100","author":"Bujan","year":"2013","journal-title":"Fertil. Steril."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1177\/1557988316661986","article-title":"Testosterone Deficiency and Bone Metabolism Damage in Testicular Cancer Survivors","volume":"12","author":"Ondrusova","year":"2018","journal-title":"Am. J. Mens. Health"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1038\/bjc.1998.226","article-title":"Analysis of risk factors for cisplatin-induced ototoxicity in patients with testicular cancer","volume":"77","author":"Bokemeyer","year":"1998","journal-title":"Br. J. Cancer"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1200\/JCO.1989.7.8.1099","article-title":"Ten-year survival and late sequelae in testicular cancer patients treated with cisplatin, vinblastine, and bleomycin","volume":"7","author":"Stoter","year":"1989","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/j.juro.2018.04.077","article-title":"Sexual Function in a Nationwide Cohort of 2,260 Survivors of Testicular Cancer after 17 Years of Followup","volume":"200","author":"Bandak","year":"2018","journal-title":"J. Urol."},{"key":"ref_69","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_70","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.1016\/S0022-5347(05)65526-7","article-title":"Organ sparing surgery for malignant germ cell tumor of the testis","volume":"166","author":"Heidenreich","year":"2001","journal-title":"J. Urol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1111\/j.1464-410X.1989.tb05292.x","article-title":"Is routine pre-treatment cryopreservation of semen worthwhile in the management of patients with testicular cancer?","volume":"64","author":"Aass","year":"1989","journal-title":"Br. J. Urol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1111\/j.1464-410X.1986.tb09062.x","article-title":"Post-treatment Fertility in Patients with Testicular Cancer: III. Influence of Radiotherapy in Seminoma Patients","volume":"58","author":"Normann","year":"1986","journal-title":"Br. J. Urol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"182.e1","DOI":"10.1016\/j.jtct.2020.10.020","article-title":"Impact of Allogeneic Stem Cell Transplantation on Testicular and Sexual Function","volume":"27","author":"Zavattaro","year":"2021","journal-title":"Transpl. Cell Ther."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1200\/JCO.1997.15.4.1444","article-title":"Sexuality and fertility in long-term survivors of testicular cancer","volume":"15","author":"Arai","year":"1997","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"264","DOI":"10.3389\/fendo.2019.00264","article-title":"Hypogonadism and Sexual Dysfunction in Testicular Tumor Survivors: A Systematic Review","volume":"10","author":"Cannarella","year":"2019","journal-title":"Front. Endocrinol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/j.jsxm.2019.05.005","article-title":"Sexual Dysfunction and Reproductive Concerns in Young Men Diagnosed With Testicular Cancer: An Observational Study","volume":"16","author":"Ljungman","year":"2019","journal-title":"J. Sex. Med."},{"key":"ref_77","first-page":"457","article-title":"High prevalence of hypogonadism determined by serum free testosterone level in Japanese testicular cancer survivors","volume":"25","author":"Kurobe","year":"2018","journal-title":"Int. J. Urol. Off. J. Jpn. Urol. Assoc."},{"key":"ref_78","first-page":"651","article-title":"Impacts of treatments of testicular tumor on the sexual and reproductive functions of the patients","volume":"25","author":"Gao","year":"2019","journal-title":"Zhonghua Nan Ke Xue Natl. J. Androl."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/0090-4295(76)90558-6","article-title":"Sexual function and fecundity after treatment for testicular tumors","volume":"7","author":"Bracken","year":"1976","journal-title":"Urology"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.clgc.2023.07.004","article-title":"Testicular Radiomics To Predict Pathology At Time of Postchemotherapy Retroperitoneal Lymph Node Dissection for Nonseminomatous Germ Cell Tumor","volume":"22","author":"Venishetty","year":"2024","journal-title":"Clin. Genitourin. Cancer"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1016\/S0090-4295(94)80002-2","article-title":"Nonseminomatous germ cell tumors of the testis: Current concepts and controversies","volume":"44","author":"Sheinfeld","year":"1994","journal-title":"Urology"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.eururo.2023.04.010","article-title":"European Association of Urology Guidelines on Testicular Cancer: 2023 Update","volume":"84","author":"Patrikidou","year":"2023","journal-title":"Eur. Urol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1097\/JU.0000000000001301","article-title":"Robotic Assisted Retroperitoneal Lymph Node Dissection for Small Volume Metastatic Testicular Cancer","volume":"204","author":"Hiester","year":"2020","journal-title":"J. Urol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1097\/MOU.0000000000000938","article-title":"Intricacies of retroperitoneal lymph node dissection for testis cancer","volume":"32","author":"Alsyouf","year":"2022","journal-title":"Curr. Opin. Urol."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"1529","DOI":"10.6004\/jnccn.2019.0058","article-title":"Testicular Cancer, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology","volume":"17","author":"Gilligan","year":"2019","journal-title":"J. Natl. Compr. Cancer Netw. JNCCN"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/j.euo.2021.02.002","article-title":"Unilateral or Bilateral Retroperitoneal Lymph Node Dissection in Nonseminoma Patients with Postchemotherapy Residual Tumour? Results from RETROP, a Population-based Mapping Study by the Swedish Norwegian Testicular Cancer Group","volume":"5","author":"Gerdtsson","year":"2022","journal-title":"Eur. Urol. Oncol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.urolonc.2018.09.009","article-title":"Current controversies on the role of retroperitoneal lymphadenectomy for testicular cancer","volume":"37","author":"Mano","year":"2019","journal-title":"Urol. Oncol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"3009","DOI":"10.1200\/JCO.22.00624","article-title":"Surgery in Early Metastatic Seminoma: A Phase II Trial of Retroperitoneal Lymph Node Dissection for Testicular Seminoma With Limited Retroperitoneal Lymphadenopathy","volume":"41","author":"Daneshmand","year":"2023","journal-title":"J. Clin. Oncol. Off. J. Am. Soc. Clin. Oncol."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1097\/JU.0000000000001364","article-title":"Comparative Effectiveness of Surveillance, Primary Chemotherapy, Radiotherapy and Retroperitoneal Lymph Node Dissection for the Management of Early Stage Testicular Germ Cell Tumors: A Systematic Review","volume":"205","author":"Pierorazio","year":"2021","journal-title":"J. Urol."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1097\/MOU.0000000000001094","article-title":"Robotic-assisted retroperitoneal lymph node dissection for testicular cancer","volume":"33","author":"Gereta","year":"2023","journal-title":"Curr. Opin. Urol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1111\/ans.17323","article-title":"Outcomes of retroperitoneal lymph node dissection for testicular cancer by a high volume surgeon from Australia: A case for centralisation","volume":"92","author":"Williams","year":"2022","journal-title":"ANZ J. Surg."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"3833","DOI":"10.1007\/s00345-021-03712-7","article-title":"Outcomes of post-chemotherapy robot-assisted retroperitoneal lymph node dissection in testicular cancer: Multi-institutional study","volume":"39","author":"Rocco","year":"2021","journal-title":"World J. Urol."},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Mottaran, A., Ercolino, A., Bianchi, L., Piazza, P., Manes, F., Amirhassankhani, S., Salvador, M., Chessa, F., Corcioni, B., and Bertaccini, A. (2023). Twenty Years\u2019 Experience in Retroperitoneal Lymph Node Dissection for Testicular Cancer in a Tertiary Referral Center. Medicina, 59.","DOI":"10.3390\/medicina59010133"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/MOU.0000000000000582","article-title":"Robotic retroperitoneal lymph node dissection for testicular cancer: Feasibility and latest outcomes","volume":"29","author":"Mittakanti","year":"2019","journal-title":"Curr. Opin. Urol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"2724","DOI":"10.1002\/cncr.31390","article-title":"Temporal trends in management and outcomes of testicular cancer: A population-based study","volume":"124","author":"Leveridge","year":"2018","journal-title":"Cancer"},{"key":"ref_96","first-page":"661","article-title":"Editorial Comment: Practice Patterns and Impact of Postchemotherapy Retroperitoneal Lymph Node Dissection on Testicular Cancer Outcomes","volume":"46","year":"2020","journal-title":"Int. Braz. J. Urol. Off. J. Braz. Soc. Urol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1097\/JU.0000000000002369","article-title":"Association of Lymph Node Count and Survival after Primary Retroperitoneal Lymphadenectomy for Nonseminomatous Testicular Cancer","volume":"207","author":"Patel","year":"2022","journal-title":"J. Urol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1016\/j.euo.2019.01.014","article-title":"Robotic Postchemotherapy Retroperitoneal Lymph Node Dissection for Testicular Cancer","volume":"4","author":"Li","year":"2021","journal-title":"Eur. Urol. Oncol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1002\/jso.2930380310","article-title":"Sexual function after surgery and combination chemotherapy in men with disseminated nonseminomatous testicular cancer","volume":"38","author":"Nijman","year":"1988","journal-title":"J. Surg. Oncol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1016\/S0022-5347(17)55029-6","article-title":"Complications of Retroperitoneal Lymph Node Dissection","volume":"125","author":"Donohue","year":"1981","journal-title":"J. Urol."},{"key":"ref_101","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_102","first-page":"125","article-title":"Psychological aspects of testicular cancer","volume":"6","author":"Gorzynski","year":"1979","journal-title":"Semin. Oncol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/S0022-5347(17)32755-6","article-title":"Nerve Sparing Retroperitoneal Lymphadenectomy After Primary Chemotherapy for Metastatic Testicular Carcinoma","volume":"152","author":"Wahle","year":"1994","journal-title":"J. Urol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"1656","DOI":"10.1016\/S0022-5347(01)65476-4","article-title":"Nerve Sparing Post-Chemotherapy Retroperitoneal Lymph Node Dissection for Advanced Testicular Cancer","volume":"156","author":"Coogan","year":"1996","journal-title":"J. Urol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1590\/s1677-5538.ibju.2023.0389","article-title":"Robot-assisted retroperitoneal lymph node dissection as primary treatment for stage II seminoma germ cell tumor","volume":"50","author":"Badan","year":"2024","journal-title":"Int. Braz. J. Urol. Off. J. Braz. Soc. Urol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.ajur.2022.03.010","article-title":"Robotic-assisted retroperitoneal lymph node dissection for stage II testicular cancer","volume":"11","author":"McClintock","year":"2024","journal-title":"Asian J. Urol."},{"key":"ref_107","first-page":"379","article-title":"Post-chemotherapy nerve-sparing retroperitoneal lymph node dissection for advanced germ cell tumor","volume":"16","author":"Miki","year":"2009","journal-title":"Int. J. Urol. Off. J. Jpn. Urol. Assoc."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1111\/j.1464-410X.2009.08888.x","article-title":"Morbidity of open retroperitoneal lymph node dissection for testicular cancer: Contemporary perioperative data","volume":"105","author":"Williams","year":"2010","journal-title":"BJU Int."},{"key":"ref_109","first-page":"1044","article-title":"Sexual function using the EORTC QLQ-TC26 in testicular cancer survivors: A multi-institutional, cross-sectional study","volume":"30","author":"Koyama","year":"2023","journal-title":"Int. J. Urol. Off. J. Jpn. Urol. Assoc."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/bju.14455","article-title":"Fertility managment in testicular cancer: The need to establish a standardized and evidence-based patient-centric pathway","volume":"123","author":"Moody","year":"2019","journal-title":"BJU Int."},{"key":"ref_111","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. Res. Pract.","DOI":"10.1007\/s11764-023-01489-9"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/j.bulcan.2019.03.020","article-title":"Sexual dysfunctions of patients treated with orchidectmoy, chemotherapy and retroperitoneal lymphadenectomy, need for systematic andrological care?","volume":"106","author":"Barkatz","year":"2019","journal-title":"Bull. Cancer"},{"key":"ref_113","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_114","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1007\/s11764-010-0135-9","article-title":"Fertility in patients treated for testicular cancer","volume":"4","author":"Matos","year":"2010","journal-title":"J. Cancer Surviv. Res. Pract."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.ucl.2007.02.014","article-title":"Nerve-sparing retroperitoneal lymphadenectomy","volume":"34","author":"Jewett","year":"2007","journal-title":"Urol. Clin. N. Am."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1097\/MOU.0000000000001100","article-title":"Nerve-sparing technique in RPLND for testicular cancer","volume":"33","author":"Nalavenkata","year":"2023","journal-title":"Curr. Opin. Urol."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/4\/586\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:21:58Z","timestamp":1760106118000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/4\/586"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,31]]},"references-count":116,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4]]}},"alternative-id":["medicina60040586"],"URL":"https:\/\/doi.org\/10.3390\/medicina60040586","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,31]]}}}