Post‐treatment Fertility in Patients with Testicular Cancer: I. Influence of Retroperitoneal Lymph Node Dissection on Ejaculatory Potency

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Abstract
Dry ejaculation occurred in none of 15 patients with testicular cancer treated by right-sided retroperitoneal lymph node dissection (RLND). After left-sided and bilateral RLND, dry ejaculation was observed in 7/21 and 51/61 men, respectively. Twelve of 21 patients with dry ejaculation or small volumes of seminal fluid had ture retrograde ejaculation. In 7 of 10 men the ejaculatory volume increases significantly after treatment with imipramine chloride. Four men impregnated their wives during treatment with the drug. Without impairing the results of therapy it is possible to spare fibers from the sympathetic chains and pre-sacral plexus during RLND due to testicular cancer, thus preserving fertility in at least 40% of patients.