Ejaculatory status and fertility rates after primary retroperitoneal lymph node dissection.

Purpose: We determined the incidence of antegrade emission after primary retroperitoneal lymph node dissection in a large contemporary cohort. Our secondary purpose was to evaluate the fertility rate in this population.

Materials And Methods: We queried the testicular cancer database at our institution from January 1, 2000 to December 31, 2005 and identified all 280 patients who underwent primary retroperitoneal lymph node dissection. Of these patients we contacted 176, and questioned them about ejaculatory and fertility status at 3 to 9 years of followup.

Results: Of 176 patients who underwent primary retroperitoneal lymph node dissection 171 (97%) reported preserved antegrade emission. Of the 135 men who underwent a nerve sparing procedure 134 (99%) could ejaculate, as could 33 of 37 (89%) who underwent nonnerve sparing surgery. An attempt to father children was reported by 64 men, of whom 47 (73.4%) were successful. Three other patients fathered children via in vitro fertilization.

Conclusions: Most men who undergo modern primary retroperitoneal lymph node dissection maintain antegrade emission and ejaculation.