Retrograde ejaculation after anterior interbody lumbar fusion

Abstract

Retrograde ejaculation as a complication of anterior interbody lumbar fusion was investigated. The diagnosis of retrograde ejaculation was made on the basis of interviews. Patients were informed of the risk of retrograde ejaculation preoperatively. At the follow-up study the patients were asked if they had noticed retrograde ejaculation after their operation. In one case (anejaculation) testis biopsy and vasography was performed. On average, the incidence of retrograde ejaculation as a complication of anterior interbody lumbar fusion has been very low, ranging from only a few cases up to 5.9% of cases involving male patients. We studied 40 male patients with severe low back pain retrospectively after they had undergone anterior interbody lumbar fusion. The mean age at operation was 31.9 years and the mean follow-up time 5.0 years. Retrograde ejaculation occurred after anterior interbody fusion in nine patients. Permanent retrograde ejaculation developed in seven of these patients (17.5%). These patients were all operated on using a transabdominal approach. Major bleeding during the operation (over 2500 ml) was observed in two patients. Seven patients with retrograde ejaculation had undergone a two-level operation (L4-SI), and eight patients had undergone between one and three previous spine operations. Retrograde ejaculation has been underestimated as a complication of anterior interbody fusion in multioperated low back patients. The possibility of this complication should be kept in mind when planning a transabdominal approach for interbody lumbar fusion in male patients. We do not recommend the transabdominal approach in male patients because of the risk of retrograde ejaculation.

A prospective, randomised controlled trial of femoral ring allograft versus a titanium cage in circumferential lumbar spinal fusion with minimum 2-year clinical results

“…The breakage of translaminar screws was seen more frequently in the TC group, although this did not reach a statistical significance (p=0.178). One patient in each group (2.5%) reported retrograde ejaculation, again in keeping with previously reported incidences with a retroperitoneal approach [34,37].…”

Evaluation of the location of intervertebral cages during oblique lateral interbody fusion surgery to achieve sagittal correction

“…Sometimes more invasive corrective osteotomy surgeries such as pedicle subtraction osteotomy 6) or vertebral column resection 7,8) are performed to achieve more dramatic LL correction, but these procedures are invasive and associated with massive hemorrhaging after osteotomy and epidural bleeding [9][10][11] . Surgical procedures associated with effective sagittal alignment correction other than posterior surgery include anterior lumbar interbody fusion and lumbar lateral interbody fusion (LLIF), which enables surgeons to approach the anterior spine with the least amount of exposure and perform anterior column interbody fusion by using cages designed for oblique or lateral placement.…”

Retrograde ejaculation after retroperitoneal lower lumbar interbody fusion

“…Male genital dysfunction was recognised as a complication in the 60s and 70s [4,7,13,16], and an incidence of up to 20% has been reported using the transperitoneal approach [19]. Some surgeons have been deterred from carrying out these pro-cedures as a result, but new implants, such as cages and disc replacements, have again favoured the anterior approach.…”