Adaptive behavioral responses to potential infertility among survivors of testis cancer.

1990 ◽  
Vol 8 (2) ◽  
pp. 347-355 ◽  
Author(s):  
P P Rieker ◽  
E M Fitzgerald ◽  
L A Kalish
Keyword(s):  
College Graduates ◽  
Retroperitoneal Lymph Node Dissection ◽  
Testis Cancer ◽  
Adaptive Responses ◽  
Retroperitoneal Lymph Node ◽  
Complex Process ◽  
Married Men ◽  
Ejaculatory Dysfunction ◽  
College Educated

In a retrospective study of 153 testis cancer survivors, we examined the sociodemographic and clinical determinants of attitudes and behaviors toward illness-induced infertility. Five fertility adjustment responses were identified: sperm-banking awareness (SBA); adoption awareness (AA); fertility testing (FT); trying to father children (TFC); and fertility distress (FD). Although responses to infertility are multidetermined, these data demonstrate there is a distinct sociodemographic and clinical profile for the subgroups of men who engage in different fertility-related behaviors. Multivariate analysis results show that men most likely to be concerned with banking sperm are those who at diagnosis are younger (less than 35 years), childless, college educated, and whose relationships have become strained. Men who sought fertility tests were childless, college graduates, and able to ejaculate. The only factor predicting adoption was childlessness. Those married men attempting to father children were also less than 35 years of age at diagnosis and without ejaculatory dysfunction. The men at greatest risk for continued distress about infertility were those who remained childless and had posttreatment ejaculatory dysfunction. Residual infertility distress also was significantly associated with treatments that included extensive retroperitoneal lymph node dissection (RPLND) surgery, indicating that the latter is a "risk factor" in survivors' long-term distress. These data, while not definitive, show that the prerogative to have children is very important to men and that losing it sets into motion a range of both adverse emotions and adaptive responses. Adjustment to infertility is a complex process that begins at diagnosis and extends long after treatment is completed.

Curative testis cancer therapy: psychosocial sequelae.

1985 ◽  
Vol 3 (8) ◽  
pp. 1117-1126 ◽  
Author(s):  
P P Rieker ◽  
S D Edbril ◽  
M B Garnick
Keyword(s):  
Intimate Relationships ◽  
Psychological Symptoms ◽  
Retroperitoneal Lymph Node Dissection ◽  
Testis Cancer ◽  
Emotional States ◽  
Delayed Effects ◽  
Psychosocial Sequelae ◽  
Ejaculatory Dysfunction ◽  
Long Term Impact

We examined the long-term impact of advanced testis cancer and its curative therapies on emotional states and outlook on life, employment, intimate relationships, and sexual function. The sample consisted of 74 nonseminomatous and seminomatous tumor patients who had completed treatment two to ten years ago. The majority of men felt that surviving the debilitating treatment(s) was both an accomplishment and worthwhile trade-off. Neither the rate of unemployment (7%) nor divorce (10%) was remarkable. The most critical outcome was in the area of sexual functioning. One fourth to one half of the men reported some type of sexual impairment. Multiple regression results indicate that ejaculatory dysfunction, a side effect of the retroperitoneal lymph node dissection, is significantly associated with distress about both infertility and sexual impairment. Men with sexual impairment report more psychological symptoms, strained intimate relationships, and negative changes in other areas of life functioning. These data, while not definitive, suggest that there are delayed effects and that the subgroup of men, who are least likely to disclose these problems to physicians, are at greater risk for the deleterious outcomes.

427: Long Term Results of Laparoscopic Retroperitoneal Lymph Node Dissection in Clinical Stage I NSGCT

2005 ◽  
Vol 173 (4S) ◽  
pp. 116-117
Author(s):  
Hannes Steiner ◽  
Reinhard Peschel ◽  
Tilko Müller ◽  
Christian Gozzi ◽  
Georg C. Bartsch ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Clinical Stage ◽  
Stage I ◽  
Long Term Results ◽  
Retroperitoneal Lymph Node Dissection ◽  
Node Dissection ◽  
Retroperitoneal Lymph Node

Laparoscopic retroperitoneal lymph node dissection in stage a nonseminomatous testis cancer

Urology ◽  
1993 ◽  
Vol 42 (5) ◽  
pp. 610-614 ◽  
Author(s):  
Nelson N. Stone ◽  
Richard N. Schlussel ◽  
Robert L. Waterhouse ◽  
Pamela Unger
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Retroperitoneal Lymph Node Dissection ◽  
Testis Cancer ◽  
Node Dissection ◽  
Retroperitoneal Lymph Node

Vascular anomalies in patients undergoing retroperitoneal lymph node dissection.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 382-382
Author(s):  
Andrea K. Thissen ◽  
Daniel Porres ◽  
David J. K. P. Pfister ◽  
Charlotte Piper ◽  
Axel Heidenreich
Keyword(s):  
Lymph Node ◽  
Renal Vein ◽  
Left Renal Vein ◽  
Germ Cell Tumors ◽  
Vena Cava ◽  
Vascular Anomalies ◽  
Retroperitoneal Lymph Node Dissection ◽  
Testis Cancer ◽  
Renal Veins ◽  
Retroperitoneal Lymph Node

382 Background: Anomalies of the renal vessels usually are clinically silent and might depicted during CT scanning of the abdomen for staging purposes of urological malignancies. Awareness of these rare anomalies is crucial especially in patients undergoing staging for germ cell tumors in order to avoid overstaging and unnecessary therapy. We report on the incidence of renal vessel anomalies in an unselected group of patients undergoing retroperitoneal lymph node dissection (RPLND) for testis cancer. Methods: 245 patients with testicular germ cell tumors underwent primary or secondary RPLND following inductive chemotherapy. Prior to RPLND, all patients underwent abdominal staging by CT scans or by MRI in selected cases. CT scans were reviewed with regard to the detection of vascular anomalies of the vena cava inf., renal veins, renal arteries, and iliac vessels. CT findings were correlated with intraoperative findings. Results: Overall, vascular anomalies were encountered in 39 patients (15.9%): retroaortic left renal vein in 10 (4.1%), circumaortic left renal vein in two (0.8%), reduplication of the common iliac vein in one (0.4%), accessory renal arteries in 14 (5.7%), thrombosis of the inferior vena cava in 12 (4.9%) patients with IIC disease. Anomalies of the renal vein were detected in 10 out of 12 (83%), in two cases venous anomalies were falsely diagnosed as lymph node disease in stage I NSGCT. All arterial anomalies were identified preoperatively. CT scan identified caval thrombosis in only eight cases (68%), four cases were identified by an additional MRI of the abdomen. Conclusions: Vascular anomalies are frequently encountered in patients with RPLND for testis cancer and have to be acknowledged during surgery even with negative imaging studies. Retroaortic renal veins represent a potential pitfall of CT imaging resulting in unnecessary therapy; it should be considered in pts with CT suspicious lymph nodes caudal to the renal hilus. IVC thrombosis is associated with advanced disease and is best diagnosed by MRI of the abdomen.

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