Sperm banking is frequently carried out prior to the procedure (as with chemotherapy), as there is a risk that RPLND may damage the nerves involved in ejaculation, causing ejaculation to occur internally into the bladder rather than externally.Many patients are instead choosing surveillance, where no further surgery is performed unless tests indicate that the cancer has returned. This approach maintains a high cure rate because of the growing accuracy of surveillance techniques. Adjuvant treatment
Since testicular cancers can spread, patients are usually offered adjuvant treatment - in the form of chemotherapy or radiotherapy - to kill any cancerous cells that may exist outside of the affected testicle. The type of adjuvant therapy depends largely on the histology of the tumor (i.e. the size and shape of its cells under the microscope) and the stage of progression at the time of surgery (i.e. how far cells have escaped from the testicle, invaded the surrounding tissue, or spread to the rest of the body). If the cancer is not particularly advanced, patients may be offered careful surveillance by periodic CT scans and blood tests, in place of adjuvant treatment.Before 1970, survival rates from testicular cancer were low. Since the introduction of adjuvant chemotherapy, chiefly platinum-based drugs like cisplatin and carboplatin, the outlook has improved substantially. Although 7000 to 8000 new cases of testicular cancer occur in the United States yearly, only 400 men are expected to die of the disease.
At least three out of five criteria yields sensitivity and specificity of 95 and 91%: 

Age at onset ≥ 50 years
New onset headache with localized tenderness
Temporal artery tenderness or decreased pulsation
Elevated ESR ≥ 50 mm/hour Westergren
Temporal artery biopsy showing vasculitis with mononuclear cell infiltrate or granulomatous inflammation, usually with multinucleated giant cells

Medium vessel vasculitis
These conditions are sometimes considered together with the small vessel vasculitides.Polyarteritis nodosa (PAN). Systemic necrotizing vasculitis and aneurysm formation affecting both medium and small arteries. If only small vessels are affected, it is called microscopic polyangiitis, although it is more associated with granulomatosis with polyangiitis than to classic PAN. At least 3 out of 10 criteria yields sensitivity and specificity of 82 and 87%:

Unexplained weight loss > 4 kg
Livedo reticularis
Testicular pain
Myalgias, weakness
Abdominal pain, diarrhea, and GI bleeding
Mononeuropathy or polyneuropathy
New onset diastolic blood pressure > 90 mmHg
Elevated serum blood urea nitrogen (> 40 mg/dL) or serum creatinine (> 1.5 mg/dL)
Hepatitis B infection
Arteriographic abnormalities
Arterial biopsy showing polymorphonuclear cellsKawasaki disease. Usually in children (age<4), it affects large, medium, and small vessels, prominently the coronary arteries. Associated with a mucocutaneous lymph node syndrome. Diagnosis requires fever lasting five days or more with at least four out of five criteria:

Bilateral conjunctival injection
Injected or fissured lips, injected pharynx, or strawberry tongue
Erythema of palms/soles, edema of hands/feet, periungual desquamation
Polymorphous rash
Cervical lymphadenopathy (at least one node > 1.5 cm)Isolated cerebral vasculitis. Affects medium and small arteries over a diffuse CNS area, without symptomatic extracranial vessel involvement. Patients have CNS symptoms as well as cerebral vasculitis by angiography and leptomeningeal biopsy.