RT Journal
A1 DEPALMA RG
T1 PReservation of erectile function-reply
JF Archives of Surgery
JO Archives of Surgery
YR 1979
FD February 1
VO 114
IS 2
SP 226
OP 226
DO 10.1001/archsurg.1979.01370260116024
UL http://dx.doi.org/10.1001/archsurg.1979.01370260116024
AB In Reply.—I agree with Dr Barnhouse's observations. Retroperitoneal lymph node dissections for testicular tumor entail complete mobilization of the aorta and vena cava from renal pedicles to the bifurcations. Clearing of only one of the common iliacs and ipsilateral sympathectomy may be associated with normal erectile function. This has also been the experience of my own colleagues in urology.In avoiding dissection and division of the inferior mesenteric artery, I have taken into account the extreme variability of origin of this vessel. It is frequently with a few centimeters of the aortic bifurcation. As Dr Barnhouse recognized, it is important to preserve one nerve plexus about the common iliac artery. This probably is the left one; it is important to note that both neural anatomy as well as location of the inferior mesenteric origin vary. My reason for suggesting preservation of the inferior mesenteric artery is that this step