title: Retrograde ejaculation after anterior lumbar spine surgery.
abstract: METHODS
  A retrospective cohort study.
  
  
  OBJECTIVE
  To compare the incidence of retrograde ejaculation (RE) after anterior lumbar spine surgery with disc replacement versus fusion with the use of recombinant human bone morphogenetic protein-2 (BMP).
  
  
  BACKGROUND
  Anterior lumbar interbody fusion (ALIF) has become a popular choice for treating a number of pathologies, largely because it preserves the posterior paravertebral muscles and ligaments. Despite these advantages, the anterior approach is also associated with various complications, one of which is RE. A recent study has questioned whether the risk of RE is increased by the use of BMP in ALIF procedures rather than by the approach alone.
  
  
  METHODS
  We conducted a retrospective review of all male patients who received ALIF using BMP or artificial disc replacement (ADR) on at least the L5-S1 level between 2004 and 2011. Medical records were evaluated for the occurrence of RE, and patients were contacted via the phone to obtain current information. The incidence of RE was then compared between the 2 anterior lumbar surgery procedures.
  
  
  RESULTS
  Of the 95 cases of anterior surgery including L5-S1, 54 patients underwent ALIF with BMP (56.8%) and 41 patients were treated with ADR (43.2%). Postoperative RE occurred in 4 of the 54 ALIF patients (7.4%) and in 4 of the 41 ADR patients (9.8%). The incidence of RE was not significantly different between groups (P = 0.7226). At latest follow-up, 1 ALIF and 1 ADR patient reported resolution of the RE.
  
  
  CONCLUSIONS
  This study found that RE occurred at a similar rate in patients treated with ADR and ALIF with BMP. The overall rate of RE after retroperitoneal anterior lumbar surgery was higher than expected, which underscores the importance of counseling patients about this risk and specifically questioning patients about the symptoms of RE at postoperative visits.
authors.affiliation: Department of Orthopaedics, The Spine Center, University of Colorado Denver, Anschutz Medical Campus, Denver, CO, USA. emily.lindley@ucdenver.edu
authors.forename: Emily M
authors.initials: EM
authors.lastname: Lindley
authors.forename: Zachary L
authors.initials: ZL
authors.lastname: McBeth
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Henry
authors.forename: Robert
authors.initials: R
authors.lastname: Cooley
authors.forename: Evalina L
authors.initials: EL
authors.lastname: Burger
authors.forename: Christopher M J
authors.initials: CM
authors.lastname: Cain
authors.forename: Vikas V
authors.initials: VV
authors.lastname: Patel
mesh_terms: D000328:Adult; D000368:Aged; D055396:Bone Morphogenetic Protein 2 / Q000009:adverse effects / Q000627:therapeutic use; D004542:Ejaculation / Q000502:physiology*; D005832:Genital Diseases, Male / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008159:Lumbar Vertebrae / Q000187:drug effects / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology*; D012189:Retrospective Studies; D012447:Sacrum / Q000187:drug effects / Q000601:surgery; D013122:Spinal Diseases / Q000601:surgery; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods; D059145:Total Disc Replacement / Q000009:adverse effects* / Q000379:methods; D055815:Young Adult
chemical_list: D055396:Bone Morphogenetic Protein 2