Objective
To examine the effect of large-volume retroperitoneal germ cell tumor on nerve fibers required for erection and e
jaculation.
Design
Retrospective case reports.
Setting
Cancer treatment center.
Patient(s)
Two male patients presenting with loss of ejaculation but preservation of erection.
Result(s)
Retroperitoneal lymph nodes lie very close to the sympathetic nerve fibers that control ejaculation. Large-volume tumors would encase the sympathetic plexuses at L1 to L3, making ejaculation impossible. Parasympathetic fibers arise from S2 to S4, so they would not be damaged, preserving erection.
Conclusion(s)
Thorough history taking is important in the investigation of infertility. Presentation with these symptoms requires further investigation at an early stage to exclude retroperitoneal tumor.