Urologie pro praxi 1/2018

Retroperitoneal lymphadenectomy in the treatment of testicular tumors

Multimodal treatment strategies in the treatment of testicular tumors may include surveillance, chemo – radiotherapy and/or retroperitoneal lymph node dissection. Retroperitoneal lymph node dissection is associated with a relatively high rate of complications such as ejaculation disorders and, as a consequence, has ceded its dominant role in the therapy of testicular tumors to chemotherapy. However, with the development of novel laparoscopic techniques, modified and nerve-sparing retroperitoneal lymph node dissection is becoming increasingly popular. The long-term tumor control achieved by the procedure in suitable patients is comparable to that in classical retroperitoneal lymph node dissection but the incidence of complications, including ejaculatory dysfunction, is significantly reduced. It is doubtful whether nerve-sparing techniques can be reliably applied for the technically demanding salvage retroperitoneal lymph node disscetion procedures which are a key part of treatment of advanced testicular tumors.

Keywords: testicular tumors, retroperitoneal lymphadenectomy, ejaculatory dysfunction, nonseminoma.