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.
• Tanner score for the stages of development of secondary sexual characteristics
• Presence of gynecomastia.
• 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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