Vas Deferense procedure during LRP (Question for Dr K)

[Nik]

Arnon, I have a question for you regarding what happens to the vas deferens during LRP? Are they cut off at the point where they join the seminal vesicles? Are they sutured or blocked off to stop sperm going into the area where the prostate used to be? I presume they are not just left hanging open for sperm to go through?

 

The reason I ask, is that in cases of prostatitis where we may have an infectious cause that has spread into the vas deferens and testicle area etc, could this not be a source of reinfection into the area where the prostate was and bladder now is, causing some kind of infectious relapse into the flesh in that area?

 

If that was a possibility of course, antibiotics may now not have any problems with penetration without the prostate tissue but bacteria may still may be highly resistant after all the repeated antibiotics used while the man had years of prostatitis?

 

I would really appreciate your correction/explanation about this.

 

Thanks in advance.

[Arnon Krongrad, MD]

The vasa are transected at the level of the ampulla, which is just proximal to insertion into the prostate. I use harmonic technology, which seals them.

Remember that the prostate is a dirty organ: It has bacteria in most cases. And that most patients who have laparoscopic prostatectomy have cancer and have no symptoms and have no post-op trouble from the theoretical construct you lay out

[Nik]

Thanks Arnon.