The treatment of ejaculation disorders after retroperitoneal lymph node dissection

Area of Science:

• Urology
• Oncology
• Reproductive Medicine

Background:

• Bilateral retroperitoneal lymph node dissection (BRPND) is a standard treatment for nonseminoma testicular tumors.
• Sexual dysfunction, particularly ejaculation disorders, is a common complication following BRPND.

Purpose of the Study:

• To evaluate the impact of BRPND on sexual function in patients with nonseminoma testicular tumors.
• To assess the efficacy of imipramine in treating post-BRPND ejaculation disorders.

Main Methods:

• Prospective study comparing sexual function before and after BRPND in 14 patients.
• Administration of oral imipramine (25 mg twice daily) to patients with ejaculation disorders.
• Assessment of antegrade ejaculation, retrograde ejaculation, and sperm parameters.

Main Results:

• 12 out of 14 patients developed ejaculation disorders post-BRPND.
• Imipramine treatment restored antegrade ejaculation in 10 patients.
• Imipramine improved sperm parameters in remaining patients, leading to pregnancies in 5 partners.

Conclusions:

• Ejaculation disorders are highly prevalent after BRPND for nonseminoma.
• Imipramine is an effective treatment for restoring antegrade ejaculation and improving fertility in these patients.
• Imipramine offers a viable therapeutic option for men desiring children after BRPND.