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This page discusses the management of side effects specific to testicular cancer and its treatment. For a review of methods to manage side effects common to all cancers and their treatments, please see the monograph Managing the Side Effects of Cancer and Cancer Treatment .

Effects of Testicular Cancer on Sexual Function and Fertility

The principal change that may occur during and after your treatment for testicular cancer is in your sex life, both your potency (ability to get an erection) and your fertility (ability to father a child).

Half of patients with germ cell cancers of the testicles have reduced or zero sperm counts and consequently impaired fertility even before treatment. Unilateral orchiectomy (removal of one testicle) does not reduce potency or fertility. However, the chemotherapy and radiation that are used for testicular cancer can lower sperm counts, and surgery to remove lymph nodes in the retroperitoneum (back of the abdomen) may affect nerves that control ejaculation.

Sexual Function

After treatment, 15% of patients cured of testicular cancer report sexual dysfunction, either impotence or retrograde ejaculation (which is most likely after retroperitoneal lymph node dissection). With retrograde ejaculation, semen goes into the bladder instead of going out through the urethra during ejaculation.

Fertility

Germ cell cancers are associated with reduced fertility in about half of the cases. Both radiation and chemotherapy reduce fertility even further. Spermatogenesis (the manufacture of sperm by the testicles) may return after chemotherapy, but it is not guaranteed. Retrograde ejaculation also impairs fertility.

Managing Sexual Side Effects

It is important to discuss these possible problems with your partner. Don't be embarrassed to talk with your doctor about problems you may be experiencing. Depending on your case, a therapist may be able to help.

If you have any thoughts about becoming a parent after treatment for testicular cancer, talk with your doctor about having your semen frozen in a sperm bank for later use.

Revision Information

  • Cashen AF, Wildes TM. The Washington Manual; Hematology and Oncology Subspeciality Consult. 2nd ed. Wolter Kluwers; 2008.

  • Dennis A. Manual of Clinical Oncology. 5th edition. Lippincott Williams & Wilkins; 2004.

  • Harrison's Principles of Internal Medicine , 14th ed. McGraw-Hill; 1998.

  • Holland JF, Frei III E. Neoplasms of the genitourinary tract. In: Cancer Medicine . American Cancer Society. Available at: http://www.nci.nih.gov/cancer%5Finformation/ . Accessed November 30, 2002.

  • Motzer RJ, Bosl GJ. Testicular cancer. In: Harrison's Principles of Internal Medicine . 14th ed. McGraw-Hill; 1998.

  • Testicular Cancer Home Page. National Cancer Institute. Available at: http://www.nci.nih.gov/cancer%5Finformation/ . Accessed November 30, 2002.