Topic Overview

Retroperitoneal lymph node dissection (RPLND) is surgery
often used to treat
testicular cancer. It is done to remove
lymph nodes that may be cancerous from the lower back
and pelvis.

During the early phases of stage I nonseminoma
testicular cancer, it can be very difficult to tell whether these lymph nodes
are cancerous without surgically removing them first. For this reason, RPLND
may be done even though there is no sign that the cancer has spread
(metastasized) beyond the testes.

For many men, the greatest risk
associated with RPLND may be sexual side effects. Besides the risks related to
any major surgery, RPLND also may lead to a condition known as retrograde
ejaculation as a result of nerve damage caused by the surgery. In retrograde
ejaculation, the semen flows from the prostate gland into the bladder rather
than through the penis and outside the body, resulting in infertility. Men who
suffer from retrograde ejaculation typically do not have erection problems or
difficulty enjoying sex.

Nerve-sparing surgery techniques can prevent retrograde ejaculation in most men who have this surgery.footnote 1

Try to find an experienced surgeon and a medical center where
many surgeries are done for your kind of cancer. Experience can make a big
difference. You will likely have fewer side effects, and you’ll recover more

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  1. National Comprehensive Cancer Network (2012). Testicular cancer. NCCN Clinical Practice Guidelines in Oncology, version 1.2012. Available online:


ByHealthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD – Internal Medicine
Specialist Medical Reviewer Christopher G. Wood, MD, FACS – Urology, Oncology

Current as ofMay 3, 2017