title: Novel presentation of retroperitoneal germ cell tumor with loss of ejaculation but preservation of erection in two patients.
abstract: OBJECTIVE
  To examine the effect of large-volume retroperitoneal germ cell tumor on nerve fibers required for erection and ejaculation.
  
  
  METHODS
  Retrospective case reports.
  
  
  METHODS
  Cancer treatment center.
  
  
  METHODS
  Two male patients presenting with loss of ejaculation but preservation of erection.
  
  
  RESULTS
  Retroperitoneal lymph nodes lie very close to the sympathetic nerve fibers that control ejaculation. Large-volume tumors would encase the sympathetic plexuses at L1 to L3, making ejaculation impossible. Parasympathetic fibers arise from S2 to S4, so they would not be damaged, preserving erection.
  
  
  CONCLUSIONS
  Thorough history taking is important in the investigation of infertility. Presentation with these symptoms requires further investigation at an early stage to exclude retroperitoneal tumor.
authors.affiliation: Mount Vernon Cancer Treatment Centre, Mount Vernon Hospital, Northwood, Middlesex, United Kingdom.
authors.forename: Claire A Stark
authors.initials: CA
authors.lastname: Toller
authors.forename: Gordon J S
authors.initials: GJ
authors.lastname: Rustin
mesh_terms: D000328:Adult; D004542:Ejaculation; D006801:Humans; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000150:complications / Q000175:diagnosis*; D010410:Penile Erection; D012186:Retroperitoneal Neoplasms / Q000150:complications / Q000175:diagnosis*; D012735:Sexual Dysfunction, Physiological / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D013564:Sympathetic Nervous System / Q000503:physiopathology