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Ejaculatory status and fertility rates after primary retroperitoneal lymph node dissection
Stephen D W Beck1, Aaron L Bey, Richard Bihrle
1Department of Urology, Indiana University Medical Center, Indianapolis, Indiana, USA. sdwbeck@iupui.edu
The Journal of Urology
|September 21, 2010
Summary
Most men retain antegrade emission and ejaculation after primary retroperitoneal lymph node dissection. This study also found a high fertility rate in these testicular cancer patients.
Area of Science:
- Urology
- Surgical Oncology
- Reproductive Medicine
Background:
- Retroperitoneal lymph node dissection (RPLND) is a standard treatment for testicular cancer.
- Concerns exist regarding the impact of RPLND on ejaculatory function and fertility.
Purpose of the Study:
- To determine the incidence of antegrade emission after primary RPLND.
- To evaluate the fertility rate in patients following RPLND.
Main Methods:
- A retrospective review of 280 patients who underwent primary RPLND between 2000 and 2005.
- Follow-up questionnaires were sent to 176 patients assessing ejaculatory and fertility status (3-9 years post-surgery).
Main Results:
- 97% of patients (171/176) reported preserved antegrade emission.
- Ejaculation was preserved in 99% of nerve-sparing vs. 89% of non-nerve-sparing procedures.
- Fertility was achieved by 73.4% (47/64) attempting conception, with 3 additional successful pregnancies via IVF.
Conclusions:
- Modern primary RPLND preserves antegrade emission and ejaculation in most patients.
- RPLND has a low impact on fertility, with a high success rate for conception.