Abstract
Multimodal treatment strategies in the treatment of testicular tumors may include surveillance, chemo - radiotherapy and/or retroperitoneallymph node dissection. Retroperitoneal lymph node dissection is associated with a relatively high rate of complicationssuch as ejaculation disorders and, as a consequence, has ceded its dominant role in the therapy of testicular tumors to chemotherapy.However, with the development of novel laparoscopic techniques, modified and nerve-sparing retroperitoneal lymph node dissectionis becoming increasingly popular.
The long-term tumor control achieved by the procedure in suitable patients is comparableto that in classical retroperitoneal lymph node dissection but the incidence of complications, including ejaculatory dysfunction, issignificantly reduced. It is doubtful whether nerve-sparing techniques can be reliably applied for the technically demanding salvageretroperitoneal lymph node disscetion procedures which are a key part of treatment of advanced testicular tumors.