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Retrograde ejaculation after anterior interbody lumbar fusion

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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.

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  1. Duncan HJM, Jonck LM (1965) The presacral plexus in anterior fusion of the lumbar spine. S Afr J Surg 3:93–96

    Google Scholar 

  2. Fairbank J, Couper J, Davies J, O'Brien J (1980) The Oswestry Low Back Pain Disability Questionnaire. Physiotherapy 66: 271–273

    Google Scholar 

  3. Flynn JC, Price CT (1984) Sexual complications of anterior fusion of the lumbar spine. Spine 9:489–492

    Google Scholar 

  4. Inoue S, et al (1984) Anterior discectomy and interbody fusion for lumbar disc herniation: a review of 350 cases. Clin Orthop 183:22–31

    Google Scholar 

  5. Johnson RM, McGuire EJ (1981) Urogenital complications of anterior approaches to the lumbar spine. Clin Orthop 154:114–118

    Google Scholar 

  6. Marberger H (1974) The mechanisms of ejaculation. Basic Life Sci 4:99

    Google Scholar 

  7. Murphy JB, Lipshultz LI (1987) Abnormalities of ejaculation. Urol Clin North Am 14:583

    Google Scholar 

  8. Stauffer RN, Couentry MB (1972) Anterior interbody lumbar spinal fusion. J Bone Joint Surg [Am] 54:756–768

    Google Scholar 

  9. Suzuki J (1958) Anterior body fusion for lumbar disc herniation. J Jpn Orthop Assoc 32:948

    Google Scholar 

  10. Takahashi K, et al (1993) Sexual dysfunction after anterior lumbar interbody fusion. Symposium of International Society for the study of the lumbar spine, June 15–19, Marseilles, p 147

  11. Thomas AJ (1983) Ejaculatory dysfunction. Fertil Steril 39: 445

    Google Scholar 

  12. Weinstein MH, Machleder HI (1975) Sexual function after aorto-iliac surgery. Ann Surg 181:787

    Google Scholar 

  13. Williams DI, et al (1951) Discussion on urological complications of excision of the rectum. Proc R Soc Med 44:819

    Google Scholar 

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Tiusanen, H., Seitsalo, S., Österman, K. et al. Retrograde ejaculation after anterior interbody lumbar fusion. Eur Spine J 4, 339–342 (1995).

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