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Severe Retrograde Ejaculation following RPLND - Any tips or help?

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  • Severe Retrograde Ejaculation following RPLND - Any tips or help?

    The full impact of my recent RPLND is just now starting to hit 2 months after my surgery. I'm not sure about other guys, but in my case i don't even get any pre-seminal fluid and following orgasm absolutely nothing comes out. Is there anything out there that can help? I've heard that drugs helps some but not all guys, especially those that followed a non nerve sparing RPLND. I'm surprised there aren't any surgical procedures available to help reverse this condition since so many men are affected including prostate cancer patients.

    While googling this topic i stumbled across another forum on another website where i found many miserable and unhappy men who all suffered from this, venting and supporting each other, vastly different from the happy go lucky campers on here. The reality of it is far from pleasant and at least for me, very difficult to deal with. I hardly get as much satisfaction from orgasm as before and each time it feels more incomplete like something is missing. Its a terrible taunting feeling towards the climax and the result is far from what it used to be... it just doesn't feel like "the job is done"...

    Its really the cherry on the icing considering i already feel prematurely aged, weak and still beat up from this massive operation.

    Any help and advice would be appreciated.

  • #2
    Hey Yan

    Soonish after the surgery -- Retrograde or could it be a blockage?

    Have a look here for retro and other conditions – with retro they talk about ‘cloudy urine” after the event

    http://www.andrologyaustralia.org/pa...ULATIONPROBLEM

    Regards

    Kiwi
    >>>>>>>>>
    TC1: May 2001 / Right orchiectomy / seminoma stage 1 / Radiation
    TC2: July 2008 / Left orchiectomy / seminoma stage 1 / X2 Prostheses / Reandron (long term Testosterone injections)

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    • #3
      Its really the cherry on the icing considering i already feel prematurely aged, weak and still beat up from this massive operation.
      This part, at least, will pass.

      I think that the "happy-go-lucky" feeling you get here is just the positive energy that this crappy disease can be put down and beat. Unfortunately it is not always easily done or the way we would want. I'm sorry you are feeling the way you do and can only imagine. I am sure others with experience will chime in.

      Hang in there and stay strong, you've pretty much got this thing beat!!!
      Best,

      Zsolt


      Friendship is born at that moment when one person says to another; "What! You too? I thought I was the only one." - C.S Lewis

      “Experience: that most brutal of teachers. But you learn, my God do you learn.” - C.S. Lewis


      Mass found 11/20/08
      Left I/O 11/25/08
      Pathology: Seminoma, Stage 1
      Surveillance: All Clear since

      Comment


      • #4
        Hey Yan78...I guess you could count my hubby and I among the happy campers crowd despite the crappy luck of being retrograde post-RPLND. I gotta be honest though, the problems with sensation and satisfaction you are stating have never been problems my hubby and I have experienced since his surgery. The boys are just not swimming out...that's the set of cards we were dealt, but our sex life is no less pleasurable because of it.

        You're only two months out, it's very possible that your issue could resolve as others have experienced a full return nearly half a year out. As for your prematurely aged feeling, I'm so sorry you feel this way. I think that's mind over matter, and I hope that you will be able to find your own peace with this...regardless of the ultimate outcome. Best wishes to you.
        Maria
        *Hubby Andy diagnosed 02/13/07, Left IO 02/16/07 *Stage 1A Non-Seminoma (65% Immature Teratoma / 35% Embryonal Carcinoma) *RPLND 04/27/07 Lymph Nodes-ALL CLEAR
        *Complications from Chylous Ascites so Laparotomy 05/03/07 *No food for 10 weeks, TPN only *07/18/07 Removed drains, tubes, picc line *CT Scan 07/31/07-ALL CLEAR
        *CT Scan 02/12/08-ALL CLEAR *Hydrocele surgery 06/19/08 *CT Scan 9/30/08 and 03/06/09 shows <cm left lung nodule - under surveillance

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        • #5
          Thank you for your opinions and advice..

          I just received the operative reports, and noticed the following being repeated twice regarding the sympathetic nerves:

          "The postganglionic sympathetic fiber L3 and L4 were identified inferior to the vena cava as they crossed anterior to the aorta, encircled with white vessel loops, dissected proximally and distally from the sympathetic chain down ot he hypogastric plexus, which was freed from the inferior mesenteric artery. These nerves were preserved throughout the procedure."

          and then once more towards the end of the report:

          "at the end of the dissection, the right sympathetic chain was preserved, as was the hypogastric plexus and the right sympathetic postganglionic nerves."

          Does this mean that there is still a possibility that antegrade ejaculation may return?

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          • #6
            I would assume the same based on the reading. Based on what I have read here in the forum, it can sometimes take months for function to return.
            "Life moves pretty fast; if you don't stop and look around once in a while, you could miss it." -Ferris Bueller
            11.22.06 -Dx the day before Thanksgiving
            12.09.06 -Rt I/O; 100% seminoma, multifocal; Stage I-A; Surveillance; Six years out! I consider myself cured.

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            • #7
              Originally posted by Fed View Post
              I would assume the same based on the reading. Based on what I have read here in the forum, it can sometimes take months for function to return.
              I was initially told by Dr. Sheinfeld that he would not be able to perform a nerve sparing procedure after seeing my CT scan due to the size of the masses. So I assumed that was the case, but I have heard that if the nerves are preserved on one side, that is usually enough for antegrade ejaculation to return.

              Well, time will tell i guess.

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