Below the Belt Award

Testicular cancer (TC) is one of the most common cancers diagnosed in young men in Australia. While most men can expect a positive outcome, treatment can result in long-term side effects. Sometimes after retroperitoneal lymph node dissection (RPLND; surgery involving the lymph nodes at the back of the abdomen), important nerves controlling ejaculation can become disrupted. This results in retrograde ejaculation (RE), where sperm flows back into the bladder instead of through the penis after orgasm. It is sometimes called a dry orgasm. Although RE is not harmful or painful, it may affect sensation during orgasm and result in infertility (difficulty conceiving a pregnancy). While RE may resolve spontaneously in some men, it becomes a chronic problem for others and existing treatments are not standardised, nor always helpful or successful. We plan to conduct a pilot study exploring the effectiveness of an oral medication, pseudoephedrine (an ingredient in ‘Cold and Flu’ tablets), to improve RE following RPLND. As pseudoephedrine causes tightening of the bladder muscle, it prevents sperm flowing back into the bladder and thus helps sperm move through the penis. It is therefore a potentially effective treatment for RE. Whilst some studies in men with RE due to other causes have shown pseudoephedrine may be helpful, it is not known how effective this approach is for men with RE after RPLND. We are currently undertaking a study to help understand how common RE is after RPLND, and how it affects men’s health-related quality of life (HRQoL). To follow up, we would like to recruit men with RE following RPLND and explore the effectiveness of pseudoephedrine as a treatment and improve our understanding of the impacts that RE has on HRQoL for survivors of TC.