Iatrogenic effects of radical cancer surgery on male fertility

Fertil Steril. 2021 Sep;116(3):625-629. doi: 10.1016/j.fertnstert.2021.07.1200.

Abstract

Iatrogenic causes of male infertility can include medications, chemotherapy, radiation, and surgery. In this review, we discuss commonly performed urologic cancer surgeries and nonurologic surgeries that harbor a high risk of iatrogenic infertility. These include radical prostatectomy, radical cystectomy, retroperitoneal lymph node dissection, pelvic colon surgery, and anterior spine surgery. In addition, we review the anatomy and surgical strategies that help to reduce the risks of infertility. With an increase in life expectancy and improvements in fertility preservation, it is important to properly counsel patients about the risks of infertility and provide options for fertility preservation before surgery.

Keywords: Anejaculation; cancer surgery; cryopreservation; obstructive azoospermia; retrograde ejaculation.

Publication types

  • Review

MeSH terms

  • Azoospermia / etiology
  • Azoospermia / physiopathology
  • Azoospermia / therapy
  • Colectomy / adverse effects*
  • Cystectomy / adverse effects*
  • Ejaculation
  • Fertility
  • Fertility Preservation
  • Humans
  • Iatrogenic Disease*
  • Infertility, Male / etiology*
  • Infertility, Male / physiopathology
  • Infertility, Male / therapy
  • Lumbar Vertebrae / surgery
  • Lymph Node Excision / adverse effects*
  • Male
  • Neoplasms / surgery*
  • Orthopedic Procedures / adverse effects*
  • Prostatectomy / adverse effects*
  • Risk Factors