The updated indiana university experience with nerve sparing rplnd: effective organ preserving therapy

John P. Donohue, Richard S. Foster, Richard Bihrle, Randall G. Rowland, Gregory R. Wahle

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Organ sparing surgical therapy of testis cancer involves preservation of sympathetic efferent nerves to maintain emission and ejaculation. We reviewed the updated experience with modified nerve sparing RPLND in patients with clinical stage I nonseminoma. From 1984 to 1996, 489 clinical stage I patients were subjected to modified nerve sparing RPLND. Follow up data was developed through a computerized database and correspondence. Eighty four (37%) of 227 patients with left sided primaries were found to be pathologic stage II. Seventy nine (30%) of 262 patients with right sided primaries were found to be pathologic stage II. Overall, 163 of 489 (33% ) were pathologic stage II, Of 227 left modified nerve sparing patients, ejaculation status is currently unknown in 33 (14%). Of 262 right modified nerve sparing patients, ejaculatory status is unknown in 38 (14%). Of the 419 patients with available follow up, all report emission and antegrade ejaculation. In this cohort of patients, performance of nerve sparing had no adverse effect on ultimate outcome compared to historical controls. Modified nerve sparing RPLND in clinical stage I nonseminoma effectively and reliably preserves emission and ejaculation. Organ sparing therapy in the surgical treatment of testicular cancer has proven reliable in the long term.

Original languageEnglish (US)
Number of pages1
JournalBritish Journal of Urology
Issue numberSUPPL. 2
StatePublished - Dec 1 1997


ASJC Scopus subject areas

  • Urology

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