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Sexual function following high retroperitoneal lymphadenectomy.

K R Kedia, C Markland, E E Fraley

    The Journal of Urology
    |August 1, 1975
    PubMed
    Summary
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    High retroperitoneal lymphadenectomy causes infertility in most men due to nerve damage affecting sperm production. This suggests potential for new reversible male contraceptives targeting these nerves.

    Area of Science:

    • Urology
    • Reproductive Medicine
    • Surgical Oncology

    Background:

    • High retroperitoneal lymphadenectomy (HRL) is a surgical procedure used in cancer treatment.
    • Post-surgical infertility is a significant concern for patients undergoing HRL.
    • The precise mechanisms causing infertility after HRL require further elucidation.

    Purpose of the Study:

    • To investigate the underlying causes of infertility in patients following high retroperitoneal lymphadenectomy.
    • To determine the impact of HRL on specific reproductive functions and structures.
    • To explore potential therapeutic targets for mitigating post-surgical infertility.

    Main Methods:

    • Study included 36 patients who underwent high retroperitoneal lymphadenectomy.
    • Evaluation focused on the mechanisms of infertility, including seminal vesicle and ductus deferential function.

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  • Assessment included analysis of sperm production, potency, orgasm, and ejaculatory function.

    • Main Results:

    • Infertility was observed in 35 out of 36 patients.
    • The primary cause identified was sympathetic denervation of the seminal vesicles and ductus deferens.
    • This denervation led to aspermia (absence of sperm in ejaculate) in affected patients.
    • Potency and orgasm remained unaffected, with no instances of retrograde ejaculation.

    Conclusions:

    • Sympathetic denervation of reproductive structures is the main mechanism of infertility post-HRL.
    • The findings support the investigation of sympatholytic drugs.
    • These drugs could potentially be developed as reversible male contraceptives.