OBSERVATIONS ON THE COURSE OF EJACULATION INTO THE POSTERIOR URETHRA

Nine patients underwent retroperitoneal nerve-sparing lymph node disse ction for bilateral nonseminomatous testicular tumours (path. St. I di sease). While the isolated lumbar nerves L1, L2, L3 were electrostimul ated (30 Hz, 5-20 V), the activity of the seminal vesicles, bladder ne ck and posterior urethra was recorded by way of suprapubic transvesica l sonography and/or endoscopy. Emission started simultaneously on thre e different levels: contraction of the seminal vesicles in the periphe ry, bladder neck closure, and opening of the paracollicular space. Con tracation of the seminal vesicles extends to the midline; the prostati c urethra closes, starting at the bladder neck. Secretion from the duc tuli prostatici (milky) and from the ductucli ejaculatorii (transparen t) follow. It was confirmed by the detection of PSA (11 000-21 000 ng/ ml) in the ejaculate that prostatic secretion is also present in it. T he significance of the postganglionic nerves for emission increased fr om L1 to L3. In three patients with salvage lymph node dissection the above-mentioned ultrasound monitoring allowed differentiate nerves rel evant to emission from those not involved, allowing more comprehensive retroperitoneal resection.