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Thread: Where do sperm go after prostate removal?

  1. #1

    Where do sperm go after prostate removal?

    Does anybody know what the doctor does to the tubes from the testicles after removing the seminal vesticles and the prostate? Do they clam or tie them off, and what effect does this have on the testicles, if any? Or are they left open letting the sperm empty somewhere into the body?

    Just wondering because I've had some tenderness in my testicles since my surgery. I'm wondering if the sperm and getting all backed up in the testicles, and it may take a while for some balance to be reached where this is no longer a problem. The tenderness could just be soreness/inflammation from the surgery.

    Thanks for any information you can provide.

  2. #2

    my understanding

    My understanding is that in about 90% of men after prostatectomy, sperm travel to the bladder. This is called retrograde ejaculation and is not dangerous.

    I would see a urologist about any tenderness in the testicles. There are multiple things it could be, (inguinal hernia or epididymitis, for example, which are fairly common after prostatectomy and no big deal to fix).

    Good luck.
    Replicant

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  3. #3
    Does this mean the tubes from the testicles connect to the urethra and aren't touched during the prostate removal, and after the surgery the sperm go into the urethra and backup into the bladder?

    Thanks

  4. #4

    not sure

    I'm not that clear on how all the plumbing works down there. Maybe someone else knows?

    I had a vasectomy a few years before the prostatectomy, so my situation was a little different, I guess.
    Replicant

    Dx Feb 2006, PSA 9 @age 43
    RRP Apr 2006 - Gleason 3+4, T2c, NXMX, pos margins
    PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
    Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
    PSA 6/07 0.1, 9/07 (and thereafter) <0.1
    http://pcabefore50.blogspot.com

  5. #5
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    This is my understanding of what happens.

    During a Radical Prostatectomy the entire prostate and seminal vesicles are removed, therefore you will be unable to produce semen (the fluid that carries the sperm) following surgery. Your testicles will still make sperm cells but they will die and be reabsorbed back into your body.

    Something similar happens when you get a skin bruise. The blood is reabsorbed back into your body over time and the bruise disappears.

    Hope that helps.

    Also, to add, Replicant was correct in his post regarding Retrograde Ejaculation. I can't confirm the percentage of men this happens to, but I believe it has to do with a problem with the sphincter.
    I lost my mother to inoperable pancreatic cancer in 1990 after caring for her at home for 9 months.

    And, my husband was diagnosed with prostate cancer in 2006. Gleason 3+4=7 PSA 3.2. Treatment of choice was proton beam therapy at Loma Linda Hospital, California. His current PSA is .52 and will continue to drop as the cancer cells die off.

  6. #6
    Administrator Top User brainman's Avatar
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    Quote Originally Posted by markinphoenix
    Does this mean the tubes from the testicles connect to the urethra and aren't touched during the prostate removal, and after the surgery the sperm go into the urethra and backup into the bladder?
    It is my understanding that in both cases (prostatectomy or not), the sperms go through the vas deferens into the urethra. However, when the prostate is removed, there is nothing to stop the sperms from going into the bladder.
    Jim
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    http://cancerforums.net/viewtopic.php?t=2405
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  7. #7
    My doctor's nurse tells me the vas deferens (the tubes from the testicles) are cut and clamped/or cauterized, sealing the tubes, like is done for a vasectomy. One website I found said the testicles will eventually reduce or quit making sperm. I guess they must get a little backed up with no outlet for the sperm.

    Since the vas deferens aren't reconnected to the urethra I don't know how retrograde ejaculation could occur.

    If you do a google search for "diagram male reproductive system" and select the first item you will see a great picture of the area we are talking about. You will see the vas deferens connect through the prostate, and therefore has nowhere to connect to the urethra after the prostate is removed. I guess you don't need the sperm without the prostate to produce the fluid the sperm need to function.

  8. #8
    I think markinphoenix is on target. Reto-grade ejaculation is often the result of an enlarged prostate that constricts the outlet from the prostate to the urethra path leading to the outside world. Semen then takes the path of least resistance up to the bladder. Without a prostate there is no ejaculation of any kind, retrograde or otherwise because the fluid producing organ (the prostate) is gone. Sperm is a minute portion of a normal ejaculation. The actual mass or volume of of the sperm produced is so small I think re-absorption would be no problem.

    PS: For any that are new to the issues and concerned about this topic: Lack of ejaculation does NOT equal lack of orgasm. The two are surprisingly independent of each other. In fact, erection and orgasm are surprisingly independent of each other as many men find out in the period right after surgery when total ED is not uncommon.
    History: PSA's every 6 months 6.7 neg biopsy - PSA 16.6 neg biopsy - PSA's 8.2, 8.1, 8.7 - Biopsy showing 4+4 Gleason 8. Lap RP Apr 2004, age 52 All neg margins, nodes, and structures. (T2a). Post RP PSA: every 6 mo. <.1 until Feb, 08 (46 mos) PSA .1 - I then got sensitive tests beginning 2008: Feb .06, May .09, Jun .10, Aug .10, Nov .15 - SRT Dec 2008
    Post SRT PSA 2009 Feb .10, May .09, Aug .06, Dec .04, 2010 Mar .04

  9. #9
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    Radical prostatectomy cuts the connection between the testicles (where sperm are produced) and the urethra. This means that a man can no longer father a child by natural means. Often, this is not an issue, as men with prostate cancer tend to be older. But if it is a concern for you, you may want to speak with your doctor about "banking" your sperm before the operation.
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