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Geza de Takats, M.D.; Loring S. Helfrich, M.D.
JAMA. 1941;117(1):20-21. doi:10.1001/jama.1941.72820270001007a.
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The surgical literature contains many references to the loss of the power of ejaculation from the seminal vesicles and the prostate gland when the first lumbar sympathetic ganglion is removed.1 The preganglionic motor fibers leave the spinal column through the upper lumbar white rami and join the presacral nerve through the lumbar sympathetic chain and the lateral roots of the superior hypogastric plexus. Presacral neurectomy destroys the postganglionic neuron, and, while libido and orgasm are unimpaired, the power of ejaculation is definitely lost.2 With the wider application of high lumbar sympathectomy and section of the splanchnic nerves in our clinic for selected cases of Raynaud's disease, thrombo-angiitis obliterans, reflex dystrophy, hypertension and megacolon, the question of male sterility has frequently arisen. It might be said that in most cases of this type a hereditary factor is unmistakable and that male sterility without loss of libido and orgasm is


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