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 quickly.