Adult patients treated with ABVD develop azoospermia in 33% of cases. Recovery of spermatogenesis occurred in 67% of these patients. Abnormalities in Leydig cell function do not occur.

Retroperitoneal Lymph Node Dissection

Damage to the thoracolumbar sympathetic plexus during retroperitoneal lymph node dissection results in ejaculatory failure. Evidence of testicular damage can be determined clinically or by laboratory assessment.

Clinical Assessment

• Tanner score for the stages of development of secondary sexual characteristics

• Presence of gynecomastia.

Laboratory Assessment

• Spermatogenesis. If the patient is old enough, semen can be analyzed for sperm count, morphology, and motility

• Hormonal studies.

Table 27-12 presents an evaluation of the hypothalamic-pituitary axis using an analysis of pertinent hormonal assays.

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