The study involved 2, testicular cancer survivors in Denmark. The remaining 2, men had been treated for unilateral testicular cancer and served as a comparison group. The men completed questionnaires that assessed their erectile function, anxiety and depression symptoms, and fatigue. About a quarter of the men in the bilateral group had erectile dysfunction. Scores on the fatigue assessment were similar for the three groups. International Society for Sexual Medicine. What Are You Looking For?
Morning testosterone, luteinizing hormone, follicle-stimulating hormone and semen analysis had been ordered by the primary care physician, but tests had only been partially completed and no results were available.
What is the next best step in the management of this patient? Tell him that one testicle does not produce sufficient semen to father a child and that his efforts are futile.
Ask more questions about his relationship with his wife. Tell the patient that he is fine, and that infertility is almost always the responsibility of the female partner. Start testosterone supplementation.
Expensive lab tests often do not provide the answers to the medical challenges that confront us. In this case, the patient was working the evening shift from 4 p. His wife, a nurse, was working the morning shift at a hospital and had to leave the house around a. The couple had relations once every other week on average and, when pressed, the patient had trouble remembering the last time he had intercourse with his wife — the two were simply too exhausted and were not spending enough quality time together.
While cryptorchidism is associated with hypogonadism and testicular cancer, this man has undergone a normal development and demonstrated no clinical signs of low testosterone. One testicle is usually sufficient to produce semen and testosterone A , although decreased semen production and quality are often seen with this condition.
A testicular biopsy is not necessary as long as the semen analysis demonstrates viable sperm C , which could be used in an in vitro fertilization procedure. Testosterone supplementation would only suppress semen production and would be counterproductive in this case E.
Finally, it is a profoundly unfair and false statement to declare fertility or the lack thereof solely the responsibility of the female partner.
The cause of infertility is a female factor in approximately one-third of the cases, male factor in roughly another one-third and attributable to both partners in the remaining one-third of couples seeking treatment for fertility. When should you call for help? Where can you learn more? Top of the page. Your Recovery Orchiectomy say "or-kee-EK-tuh-mee" is surgery to remove one or both testicles.
How can you care for yourself at home? Rest when you feel tired. Getting enough sleep will help you recover. Lie down for 15 minutes several times each day for the first 2 weeks after surgery. This will help reduce the swelling of your scrotum. Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, for 2 to 3 weeks after surgery. Avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner. Do not drive for 1 to 2 weeks after surgery or until your doctor says it is okay.
You may take showers. Pat the cut incision dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay. Your doctor will tell you when you can have sex again. Most men are able to return to work or their normal activities in about 2 to 3 weeks after surgery. You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt. You may notice that your bowel movements are not regular right after your surgery.
This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative. Your doctor will tell you if and when you can restart your medicines.
He or she will also give you instructions about taking any new medicines. If you take aspirin or some other blood thinner, ask your doctor if and when to start taking it again. Make sure that you understand exactly what your doctor wants you to do. Take pain medicines exactly as directed.
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