Robotic-assisted Radical Nephrectomy

Hui-Ying LiuTaiwan Speaker Recent Advances in Fertility Preservation for Young Male Cancer SurvivorsTesticular cancer (TC) is the most common malignancy in men of reproductive age and significantly impacts fertility through both direct tumor effects and subsequent gonadotoxic treatments. Tumor-related factors such as testicular parenchymal destruction, intratesticular obstruction, elevated β-HCG levels, oxidative stress, and disruption of the hypothalamic–pituitary–gonadal axis contribute to impaired spermatogenesis and sperm DNA fragmentation. Cancer treatments including orchiectomy, chemotherapy (especially cisplatin-based regimens), retroperitoneal lymph node dissection, and radiotherapy further increase the risk of oligo- or azoospermia, with long-term recovery of spermatogenesis often taking up to 2–4 years. Despite these risks, less than one-third of patients undergo sperm cryopreservation before treatment, even though up to 50% present with abnormal semen parameters at diagnosis. Onco-TESE and electroejaculation serve as viable alternatives in select patients, while emerging evidence supports the use of testis-sparing strategies and real-time sperm retrieval in appropriate cases. Current data emphasize the necessity of early fertility counseling and preservation planning for all men diagnosed with TC. Given the high cure rate and young patient demographic, optimizing reproductive outcomes is a key component of survivorship care.