PD18-06 PREDICTORS OF AZOOSPERMIA IN MEN WITH TESTIS CANCER

Abstract

You have accessJournal of UrologyCME1 Apr 2023PD18-06 PREDICTORS OF AZOOSPERMIA IN MEN WITH TESTIS CANCER Luis F. Novaes, Richard S. Matulewicz, Joel Sheinfeld, John P. Mulhall, and Jose M. Flores Luis F. NovaesLuis F. Novaes More articles by this author , Richard S. MatulewiczRichard S. Matulewicz More articles by this author , Joel SheinfeldJoel Sheinfeld More articles by this author , John P. MulhallJohn P. Mulhall More articles by this author , and Jose M. FloresJose M. Flores More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003273.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Testis cancer (TC) is the most common cancer in young men. Many men with TC are also found to be sub-fertile at the time of diagnosis. Standard treatment modalities often negatively affect reproductive potential, making fertility a vital consideration in this population. We aimed to evaluate predictors of azoospermia in the pre-radical orchiectomy (RO) semen analysis (SA) in men with TC to inform patient counseling and guide fertility preservation. METHODS: Our analytic cohort included (i) men treated with RO for testicular cancer at our institution from January 2010 to August 2022 who had a (ii) SA, and (iii) fertility endocrine profile available prior to surgery. SA evaluated sperm concentration categorized as: azoospermia (0 M/ml), severe oligospermia (<5 M/ml), oligospermia (5-15 M/ml), normospermia (>15 M/ml). Parameters were reported as frequencies or median (IQR). Patient demographics, total testosterone (T), FSH levels, and testis ultrasound (TUS) parameters were also collected. TUS parameters analyzed were testis volume of each testis, tumor volume, number of tumors, and presence of microcalcifications. Multivariable analysis (MVA) was used to explore factors associated with azoospermia. Factors included in the model were testis volume of the side affected by tumor, tumor volume, FSH levels, and the presence of microcalcifications. RESULTS: A total of 97 men met inclusion criteria. Median age was 30 (25, 35) years. Median SA volume was 3 (1.5, 4) mL, median concentration 13 (0.3, 40) M/ml; 15% had azoospermia, 20% severe oligospermia, 19% oligospermia, 46% normospermia. Median total T was 393 (319, 529) ng/dL; 19% had T level ≤300 ng/dL. Median FSH was 18 (3, 32) IU/mL. The median testis volume was 15 (10, 23) cc, the median tumor volume was 4 (1, 18) cc. 96% of tumors were unilateral, and 29% had microcalcifications. In men with testis volume of the side affected by the tumor ≤10cc the rate of azoospermia was 21%, versus 13% in men with testis volume >10 cc. On MVA, testis volume of the side affected by the tumor was the only factor statistically associated with azoospermia. CONCLUSIONS: For men with testis cancer, lower testis volume of the side affected by the tumor is independently associated with azoospermia. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e504 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luis F. Novaes More articles by this author Richard S. Matulewicz More articles by this author Joel Sheinfeld More articles by this author John P. Mulhall More articles by this author Jose M. Flores More articles by this author Expand All Advertisement PDF downloadLoading ...