Seminal vesicle invasion in radical prostatectomies: Which is the most common route of invasion?
Very few studies have been published on seminal vesicle invasion (SVI), and these have obtained conflicting results. The aim of the present investigation was to determine the most frequent of three possible routes of seminal vesicle invasion: (1) extraprostatic extension (EPE) into soft tissue adjacent to the seminal vesicle and then into the wall of the seminal vesicle, (2) invasion via the sheath of the ejaculatory duct, penetrating the muscular wall of the ejaculatory duct or extending up the ejaculatory duct into the seminal vesicle muscle wall, or (3) discontinuous metastases.
Materials and methods
The surgical specimens of 230 consecutive patients submitted to radical prostatectomy were histologically evaluated by complete embedding and whole-mount processing.
Of the surgical specimens obtained from 230 patients, 28 (12.17%) showed the presence of either unilateral or bilateral SVI. The routes of SVI in these 28 specimens were: (1) only via the sheath of the ejaculatory duct (0/28; 0%); (2) discontinuous metastases (3/28; 11%), (3) both EPE and via the sheath of the ejaculatory duct (6/28; 21%), and (4) only EPE (19/28; 68%). One-half (14/28; 50%) of the 28 seminal vesicles involved had unilateral invasion and, in most of these cases (42.85%), EPE was unilateral and ipsilateral.
Our results suggest that the most important and most frequent route of SVI is extraprostatic extension of prostate carcinoma into the soft tissue adjacent to the ipsilateral seminal vesicle and then into the wall of the seminal vesicle.
KeywordsCarcinoma Invasion Prostate Seminal vesicle Retropubic prostatectomy
- 4.Walsh PC (1986) Radical retropubic prostatectomy. In: Walsh PC, Gittes RF, Perlmutter AD, Stamey TA, (eds) Campbell’s urology, 5th edn, vol. 3. WB Saunders, Philadelphia, pp 2754–2775Google Scholar
- 7.Gleason DF, Mellinger GT and the Veterans Administration Cooperative Urological Research Group (1974) Prediction of prognosis for prostatic adenocarcinoma by combined histological grading and clinical staging. J Urol 111:58–64Google Scholar
- 9.Humphrey PA (2003) Prostate pathology. ASCP Press, Chicago, pp 301–303Google Scholar