LOSS OF EMISSION FOLLOWING RETROPERITONEAL LYMPH NODE DISSECTION IN TESTICULAR TUMOR

Abstract

The reports of the loss of emission after retroperitoneal lymph node dissection in testicular tumors are increasing recently. A review of the literature revealed brief mention of this complication in their statistical reports by Whitmore (1962), Nagamatsu (1963), Notter (1964) and Richardson (1965), and more detailed reports by Leiter and Brendler (1967) and Kom and associates (1971).
As no report of this condition in testicular tumors was found in Japan so far, detailed study on the condition of libido, erection, orgasm and ejaculation of the adult patients who had undergone retroperitoneal lymph node dissection was attempted and the following results were obtained.
1) Loss of emission was found following retroperitoneal lymph node dissection in 6 of 8 cases, aged 24 to 43 years, even though normal erection and orgasm were present. Retrograde ejaculation was not encountered.
2) On the other hand, the emission was preserved in 15 of 16 cases treated with high orchiectomy and irradiation to the retroperitoneal lymph nodes. The remaining one case of teratomatous mixed tumor with inoperable large abdominal mass lost emission in the later stage. Total tumor dose ranged between 2, 800 and 5, 000R, did not interfere with libido, erection, ejaculation, emission and orgasm.
The problem of loss of emission in post-node dissection patients is serious, considering that there are many young patients and the survival rate is increasing recently.
It is emphasized that the indication of the retroperitoneal lymph node dissection should be carefully decided, taking into consideration not only the histological classification and staging of the tumor, but also possible occurrence of the loss of emission.