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  • Dry ejaculations?

    My son is 16 and he banked semen post-orchiectomy and before 4xBEP. He had a RPLND a month ago. We are pretty open with one another and one of my main concerns for him post-operatively was retrograde ejaculation so I finally asked him last night how things were going so-to-speak. He said that he can't ejaculate so I thought it was due to the surgery, but then he said it was like that all through chemo too. Apparently, after the orchiectomy things worked normally for a bit, but then sometime between the 3rd & 4th cycle of BEP he started having the dry ejaculations. He is kind of coming to terms and just accepting his belief that he is most likely sterile. So much for a 16 year old to deal with.

    Anyone have experience or knowledge they can share? Wondering if it was just due to chemo if things could return to normal at some point, providing the RPLND didn't cause more permanent issues in that area? Is it normal for chemo to cause this? I don't remember this being mentioned before. We will likely end up back in the urology office in a week or two and can inquire further as well.
    Last edited by TC Mom; 10-13-17, 03:08 PM.
    Mom to Zachary - dx. at the age of 15 - Stage IIIC mixed germ cell
    5.10.17 - Initial diagnosis
    Baseline markers: BhCG: 43,882 AFP: 138 LDH: 328

    5.16.17 - Left Radical orchiectomy (total tumor size 7x5x4cm)
    5.31.17 - CT Scan showed mets to retroperitoneal LNs (5.7x6.4x9.4cm, 1.7x2.6x3.5cm, 3.1x4.5x6.1cm)
    PATH: Mixed germ cell (75% teratoma, 15% embryonal ca, 8% yolk sac tumor, & 2% trophoblastic tumor) Spermatic cord margin, neg. Germ cell neoplasia in situ present.

    Post-op markers: BhCG: 73,837 AFP: 38 LDH: 412

    BEP#1 6.9.17 BhCG:77,721, AFP 34
    BEP#2 7.3.17 BhCG: 210, AFP: 6
    BEP#3 7.24.17 BhCG: 19 AFP: 3
    BEP#4 8.14.17 BhCG: 4.59 AFP: 5

    8.28.17 BhCG 2.46, AFP 6
    9.7.17 BhCG 1.78, AFP 3

    RPLND 9.14.17 - path report showed 100% teratoma in nodes removed! ALL CLEAR!

  • #2
    I have never heard of anyone having retrograde ejaculations due to chemo. Just to be clear, he does have an orgasm, but it's dry, correct?

    Dave
    Jan, 1975: Right I/O, followed by RPLND
    Dec, 2009: Left I/O, followed by 3xBEP

    Comment


    • #3
      I haven;t heard of this being chemotherapy related either. Please keep us posted on what you find out.

      Mike
      Oct. 2005 felt lump but waited over 7 months.
      06.15.06 "You have Cancer"
      06.26.06 Left I/O
      06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
      06.30.06 It's Official - Stage I Seminoma
      Surveillance...
      Founded the Testicular Cancer Society
      6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

      Comment


      • #4
        Originally posted by Davepet View Post
        I have never heard of anyone having retrograde ejaculations due to chemo. Just to be clear, he does have an orgasm, but it's dry, correct?

        Dave
        I didn't press him too much for all the details - but from what I understand yes - an orgasm, but no ejaculation. I am awaiting a call back from urology so we can get him an appointment - we will inquire into this more then. I'll update when I know more.
        Mom to Zachary - dx. at the age of 15 - Stage IIIC mixed germ cell
        5.10.17 - Initial diagnosis
        Baseline markers: BhCG: 43,882 AFP: 138 LDH: 328

        5.16.17 - Left Radical orchiectomy (total tumor size 7x5x4cm)
        5.31.17 - CT Scan showed mets to retroperitoneal LNs (5.7x6.4x9.4cm, 1.7x2.6x3.5cm, 3.1x4.5x6.1cm)
        PATH: Mixed germ cell (75% teratoma, 15% embryonal ca, 8% yolk sac tumor, & 2% trophoblastic tumor) Spermatic cord margin, neg. Germ cell neoplasia in situ present.

        Post-op markers: BhCG: 73,837 AFP: 38 LDH: 412

        BEP#1 6.9.17 BhCG:77,721, AFP 34
        BEP#2 7.3.17 BhCG: 210, AFP: 6
        BEP#3 7.24.17 BhCG: 19 AFP: 3
        BEP#4 8.14.17 BhCG: 4.59 AFP: 5

        8.28.17 BhCG 2.46, AFP 6
        9.7.17 BhCG 1.78, AFP 3

        RPLND 9.14.17 - path report showed 100% teratoma in nodes removed! ALL CLEAR!

        Comment


        • #5
          Hi! Sorry he is having so many post treatment issues.I know losing a nerve during RPLND can cause issues. Sorry if I'm asking TMI, but didn't Zach bank? You might want him to have another semen analysis done in a couple of months, along with hormone panel if it has not yet been done -takeaway from the TC Summit was to give 6 months post chemo for hormone issues and semen analysis.
          Grant never masturbated before being diagnosed- never gave a sample due to his Autism the thought stressed him out a lot. Anyway, now after post chemo RPLND he has issues with attaining any erection. I did recently have his hormones tested since he does not even have first morning erections, and his numbers are messed up. Grant is 6 months post chemo, and 4 months post RPLND.
          Thinking of you and Zach.
          Last edited by Trekga; 10-16-17, 10:43 PM.
          17 year old son Grant dx 12/21/16
          pre/o markers 12/21/16- HCG:1065.15,AFP:298.8,LDH:1119
          pre/o CT Scan 12/22/16 normal
          r/o 12/22/16
          Post r/o Elevated Markers with INCREASE 4 weeks post r/o;
          PATHLOGY: mixed maligent germ cell 8.6 x 6.2 x 5.9 cm

          -80% Embryonal, 10% Yolk Sac, 5% Teratoma, 5% Choriocarcinoma w/LVI within Spermatic Cord and invasion into Rete Testis
          2nd CT scan on 1/24/17 3 nodes 2 over 2.5, one over 3.5
          BEP x 3 1/27/17
          Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
          2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
          Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

          Comment


          • #6
            Hi TC Mom

            it is very unusual. I have not found articles / studies on this which suggests to me that chemo should not cause this. However, if it was from chemo it would be less likely to be permanent so lets hope it was indeed from chemo. Also, it is possible to have dry ejaculations most of the times but not always - i know it sounds odd but unfortunately I know what i talk about. So there is hope - and i remember he banked too.

            Comment


            • #7
              Originally posted by Trekga View Post
              Grant never masturbated before being diagnosed- never gave a sample due to his Autism the thought stressed him out a lot.
              FWIW, it isn't something you just get on your first try, it is a skill like any other that takes a little practice. So if he has never done it before, i can see him having issues doing it, especially given the extra stressors around the circumstances.

              6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
              6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
              7/7/15: bHCG 56, AFP 42, LDH 322
              7/13/15 - 9/18/15: 4xEP
              10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
              10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
              4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
              4/20/16: RPLND @ IU - teratoma only!
              9/18/2017 all clears up to this date!

              Comment


              • #8
                He did bank so we are hopefully good fertility wise; but I just hate that he has this issue on top of all that comes with TC and treatment. I'm still waiting to hear back from urology for an appointment. I'm not sure how we'd easily have another semen analysis when we can't obtain a sample at this point. I was hoping to hear that this was a common thing, or at least heard of so we would know what to expect somewhat.
                Mom to Zachary - dx. at the age of 15 - Stage IIIC mixed germ cell
                5.10.17 - Initial diagnosis
                Baseline markers: BhCG: 43,882 AFP: 138 LDH: 328

                5.16.17 - Left Radical orchiectomy (total tumor size 7x5x4cm)
                5.31.17 - CT Scan showed mets to retroperitoneal LNs (5.7x6.4x9.4cm, 1.7x2.6x3.5cm, 3.1x4.5x6.1cm)
                PATH: Mixed germ cell (75% teratoma, 15% embryonal ca, 8% yolk sac tumor, & 2% trophoblastic tumor) Spermatic cord margin, neg. Germ cell neoplasia in situ present.

                Post-op markers: BhCG: 73,837 AFP: 38 LDH: 412

                BEP#1 6.9.17 BhCG:77,721, AFP 34
                BEP#2 7.3.17 BhCG: 210, AFP: 6
                BEP#3 7.24.17 BhCG: 19 AFP: 3
                BEP#4 8.14.17 BhCG: 4.59 AFP: 5

                8.28.17 BhCG 2.46, AFP 6
                9.7.17 BhCG 1.78, AFP 3

                RPLND 9.14.17 - path report showed 100% teratoma in nodes removed! ALL CLEAR!

                Comment


                • #9
                  No, obviously, if he's having dry orgasms, there is no easy way to obtain a semen sample. My understanding is that it is possible via catheterization, and even viable sperm samples can be obtained that way, but I have no details.

                  Afraid this is not at all common and you are pretty much on new ground with this.

                  Dave
                  Jan, 1975: Right I/O, followed by RPLND
                  Dec, 2009: Left I/O, followed by 3xBEP

                  Comment


                  • #10
                    There was a doctor at the TC Summit who is an expert on TC related issues with hormones and infertility. He mentioned several ways sperm can be retrieved, but they involved a patient being placed under anesthesia. If you would like the doctor's name, let me know. He truly understands the issues for men, especially the younger patients who have post treatment issues or who were unable to bank for whatever reason.

                    could it be due to RPLND? Isn't that one of the potential side effects? Retrograde Ejaculation? I know Grant was warned about it.
                    17 year old son Grant dx 12/21/16
                    pre/o markers 12/21/16- HCG:1065.15,AFP:298.8,LDH:1119
                    pre/o CT Scan 12/22/16 normal
                    r/o 12/22/16
                    Post r/o Elevated Markers with INCREASE 4 weeks post r/o;
                    PATHLOGY: mixed maligent germ cell 8.6 x 6.2 x 5.9 cm

                    -80% Embryonal, 10% Yolk Sac, 5% Teratoma, 5% Choriocarcinoma w/LVI within Spermatic Cord and invasion into Rete Testis
                    2nd CT scan on 1/24/17 3 nodes 2 over 2.5, one over 3.5
                    BEP x 3 1/27/17
                    Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
                    2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
                    Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

                    Comment


                    • #11
                      Originally posted by Trekga View Post
                      could it be due to RPLND? Isn't that one of the potential side effects? Retrograde Ejaculation? I know Grant was warned about it.
                      In the first post, TC Mom indicated this started prior to the rplnd, during chemo.

                      Jan, 1975: Right I/O, followed by RPLND
                      Dec, 2009: Left I/O, followed by 3xBEP

                      Comment


                      • #12
                        I did see that Dave. Just wondering out loud. I believe Zach was able to produce for sperm banking. If his counts were normal, than maybe just normal "chemo fatigue" could be the cause of no ejaculation during chemo. I do know Zach lost a nerve, so that has me wondering about RPLND. I'm not a man so have no idea. I was just trying to help, since Grant was only a year older when dx. Plus, Grant is having problems (no erections at all now) not 100% the same since Grant had his hormone levels tested and several are very abnormal.
                        17 year old son Grant dx 12/21/16
                        pre/o markers 12/21/16- HCG:1065.15,AFP:298.8,LDH:1119
                        pre/o CT Scan 12/22/16 normal
                        r/o 12/22/16
                        Post r/o Elevated Markers with INCREASE 4 weeks post r/o;
                        PATHLOGY: mixed maligent germ cell 8.6 x 6.2 x 5.9 cm

                        -80% Embryonal, 10% Yolk Sac, 5% Teratoma, 5% Choriocarcinoma w/LVI within Spermatic Cord and invasion into Rete Testis
                        2nd CT scan on 1/24/17 3 nodes 2 over 2.5, one over 3.5
                        BEP x 3 1/27/17
                        Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
                        2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
                        Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

                        Comment

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