Seminal Vesicle Cyst Research Articles

The prevalence of seminal vesicle cysts in autosomal dominant polycystic kidney disease

Autosomal dominant polycystic kidney disease (ADPKD) is a systemic hereditary disorder characterized by bilateral diffuse renal cysts. Extrarenal involvement is a well known manifestation of ADPKD. Data relating to the association between seminal vesicle cysts and ADPKD are limited. The aims of this study are to evaluate the frequency of seminal vesicle cysts in ADPKD and to assess the relationship between seminal vesicle cysts, with cysts in the liver and prostate, and creatininaemia. Forty five male patients (mean age 40 years, range 13-67) were included in the study. Each subject underwent a formal interview, physical examination; and abdominal and transrectal ultrasonography. Three patients were infertile, but one of the patients also had varicocele. Seminal vesicle cysts were present in 27 (60%) patients. Liver and prostate cysts were present in 19 (42%) and five (11%) patients, respectively. There was a positive correlation between seminal vesicle cysts, cysts in the liver, and serum creatinine concentrations. Our conclusions are: (i) seminal vesicle cysts are not uncommon in ADPKD; (ii) ADPKD should be looked for in patients with seminal vesicle cysts, and (iii) the clinical significance of seminal vesicle cysts in ADPKD remains to be defined.

BILATERAL CONGENITAL CYSTS OF THE SEMINAL VESICLE WITH BILATERAL DUPLEX KIDNEYS

Congenital cyst of the seminal vesicle is a rare anomaly, which is associated with ectopic insertion of an ipsilateral ureter into the seminal vesicle or other ectopic site.3 Since the embryonic event that causes this anomaly occurs early in gestation, urinary obstruction with distant ectopic ureteral insertion may lead to dysgenesis of the involved kidney. This anomaly usually develops in a single collecting system. It is rarely associated with an ipsilateral duplex ectopic ureter, and only a few such cases have been reported.3 To our knowledge bilateral congenital cysts of the seminal vesicle in a patient with bilateral duplex kidneys have not been described previously. In a single collecting system congenital cysts of the seminal vesicle are often associated with ipsilateral renal dysgenesis. Therefore, bilateral congenital cysts of the seminal vesicle are usually fatal because of severe functional impairment of both kidneys. On the other hand, since normal or nearly normal function of the lower pole moieties develops in bilateral duplex kidneys, bilateral congenital cysts of the seminal vesicle, as in our case, are possible. In our patient mild straining to void and progression of hydronephrosis of both lower moieties may be caused by distension of the seminal vesicle cysts and associated dilated ureters. However, no thickened wall of the bladder was noted on sonography or MRI. Treatment of the seminal vesicle cyst usually is restricted to symptomatic cases. Heminephrectomy with transabdominal excision of the cyst is indicated in patients with no function of the upper renal segment, as in our case. Trans

Seminal megavesicles with adult polycystic kidney disease.

Adult polycystic kidney disease has been found in association with pathological dilatation of the seminal vesicles in six patients. These men appeared normal on clinical examination, but had azoospermia or severe oligozoospermia. They were investigated by scrotal exploration with vasography, renal and transrectal ultrasound scans (TRUS), and percutaneous puncture of the seminal vesicles in one case, before and after resection of the ejaculatory ducts. This revealed that the gross dilatation of the seminal vesicles was not caused by obstruction, but appeared to be due to atonicity (megavesicles). These ultrasonic appearances, when described previously, were incorrectly thought to be due to seminal vesicle cysts.

Sonographic diagnosis of seminal vesicle cysts in autosomal dominant polycystic kidney disease

Multiple, bilateral seminal vesicle cysts were found in a young man by transabdominal sonography. Examination of the kidneys disclosed previously unknown autosomal dominant polycystic kidney disease. This case report draws attention to the rare association between these 2 conditions. © 1998 John Wiley & Sons, Inc. J Clin Ultrasound 26:221–222, 1998.

Magnetic resonance images of hematospermia

We performed MRI (magnetic resonance imaging) in the pelvic region of 70 cases with hematospermia and conducted a study on the abnormal MRI findings to which hematospermia could be attributed. We conducted a study on the morphological anomaly and change in the signal intensity in the prostate gland and of the seminal vesicle as well as on the presence or absence of dilation in the plexus venous surrounding the deferent duct or the prostate gland out of the abnormal MRI findings. As for the seminal vesicle, the patients whose seminal vesicle was seen in higher intensity than the prostate gland in T1 weighted images were diagnosed as having hemorrhagic focus and the patients whose seminal vesicle was seen in low intensity both in T1 and T2 weighted images were diagnosed as having fibrosis caused by chronic inflammation. Abnormal MRI findings were seen in 40 out of the 70 cases (57%). Anomaly in the prostate gland was indicated in 6 (9%) cases. Abnormality in the seminal vesicle was indicated in 30 cases (43%) including hemorrhage of seminal vesicle in 25 cases, chronic inflammation in five cases and cyst of seminal vesicle in one case. In conducting an examination of the patients with hematospermia, MRI is the noninvasive and reproducible method and it is possible to identify the hemorrhagic region. Therefore, MRI is thought to be useful to identify the causal organs of hematospermia.

Renal agenesis, ureteral ectopia into seminal vesicle, vas deferens agenesis and hemivertebra: an incomplete form of caudal regression syndrome?

The association of seminal vesicle cyst and upper urinary tract malformation is well known in the literature [1]. More rarely, urogenital malformations are associated with vertebral [2] or anorectal anomalies [3]. A 35-year-old infertile man with unilateral renal and deferential agenesis, seminal vesicle cyst and hemivertebra is reported. This complex malformative syndrome has been reported previously by Sheih et al. [4] and, to our knowledge, this is the third case described in the literature.

Anal tenesmus caused by seminal vesicle cyst

Congenital cysts of the seminal vesicles with ipsilateral renal aplasia or dysplasia are rare but have been well described in the literature. We report the first case where anal tenesmus was the only presenting symptom. Another unique feature was the combination of this anomaly with a duplication of the inferior vena cava. Copyright 1997 by Elsevier Science Inc. UROLOGY 49: 139-141, 1997.

Pregnancy After Relief of Ejaculatory Duct Obstruction by Aspiration Decompression of an Ectopic Ureter

A 29-year-old white man was referred for evaluation of a 7-year history of infertility. Physical examination demonstrated normal testes and vasa. Serum testosterone and follicle-stimulating hormone levels were within normal limits. Semen analysis revealed fructose-negative azoospermia and an ejaculate volume of only 1 ml. A right seminal vesicle cyst and marked dilatation of the left seminal vesicle were observed on transrectal ultrasonography. Abdominal ultrasonography showed a normal left kidney and absence of a kidney in the right flank. On endorectal magnetic resonance imaging (MRI) the seminal vesicle cyst proved to be a dilated ectopic ureter draining a small, probably dysplastic right kidney located anterior to the iliac vessels (fig. 1). The left ejaculatory duct was obstructed within the prostatic parenchyma by extrinsic compression by the dilated right ureter.

Difficult Urethral Catheterization due to Ectopic Ureter: an Unusual Presentation of Ureteral Ectopia in a Man

We report the unusual presentation of an ectopic ureter in a man with a solitary kidney. The presenting symptom was the inability to place a Foley catheter into the bladder because of preferential passage into the ectopic ureteral opening in the prostatic urethra. Flexible cystoscopy was helpful in diagnosis and management of the problem. The differential diagnosis of a difficult urethral catheterization should include occult congenital genitourinary anomalies.

Giant Müllerian Duct Cyst Mimicking Prostatic Malignancy

A giant müllerian duct cyst was initially interpreted as a seminal vesicle cyst. Associated prostatic malignancy was suspected because of raised tumour marker levels and lysis of pubic bone. Intraoperative vasography gave the correct diagnosis. Open partial transvesical excision of the cyst and suprapubic prostatectomy were performed. No malignancy was found in the surgical specimens and 2 years later the patient remains well.

Endourologic Management of Seminal Vesicle Cyst

Cystic lesions in the region of the seminal vesicles, ejaculatory ducts, or prostate are rare and can be a diagnostic and therapeutic challenge. Open surgery is often necessary for definitive treatment. Recent refinements in transrectal ultrasound imaging and endoscopic instrumentation have expanded the roles of these modalities in the management of retrovesical cysts. We present a case in which a semirigid 6.9F ureteroscope was used to access and drain a seminal vesicle cyst transurethrally, thereby obviating open surgery.

Low imperforate anus associated with seminal vesicle cyst, posterior urethral valve, and lung hypoplasia

This report describes the association of a low imperforate anus with a seminal vesicle cyst, posterior urethral valve, and lung hypoplasia complicated by necrotizing enterocolitis and unilateral vesicoureteral reflux. The embryological basis, diagnosis, and management of these anomalies is reviewed.

Chronic hematospermia: Assessment by transrectal ultrasound

Objective. To evaluate transrectal ultrasound in the assessment of chronic hematospermia. Methods. Twenty-six patients aged between twenty-five and seventy-seven years (mean, 55.6 years) presenting with persistent hematospermia of an average duration of 10.2 months (range, 3 to 20 months) underwent transrectal ultrasound. Twenty-five asymptomatic men aged thirty-nine to eighty-two years (mean, 63 years) self referred to our institution seeking transrectal ultrasound as a screening method for prostate cancer and with no previous history of hematospermia were used as controls. Results. Significant sonographic findings not present in the control group were detected in 24 patients with hematospermia. These consisted of dilated seminal vesicles in 8, ejaculatory duct cysts in 4, ejaculatory or seminal vesicle calculi in 4, the presence of ejaculatory duct and seminal vesicle dilatation in 4, seminal vesicle cysts with ipsilateral renal agenesis and absence of the vas in 2, and an intraprostatic mullerian duct remnant in 2. Of the patients having biopsies, none was found to have malignancy. Conclusions. Transrectal ultrasound is the imaging modality of choice in the assessment of chronic hematospermia.

Seminal Vesicle Cyst Associated with Ipsilateral Renal Malformation and Hemivertebra: Report of 2 Cases

Two cases of a seminal vesicle cyst, ipsilateral renal malformation and a hemivertebra are reported.

Seminal Vesicle Cyst, Renal Agenesis and Epididymitis in a 50-year-old Patient

Seminal Vesicle Cyst, Renal Agenesis and Epididymitis in a 50-year-old Patient

Seminal vesicle cysts: association with adult polycystic kidney disease.

Adult polycystic kidney disease (APKD) is associated with cyst formation in the kidney, liver, pancreas, esophagus, ovary, uterus, and brain. Four patients with APKD (aged 45-65 years) with computed tomographic evidence of seminal vesicle cysts are described. All seminal vesicles contained cystic masses with attenuation values of 0-30 HU. Seminal vesicle thickness was 3-4 cm (normal, 1.5 cm). High-attenuation walls separated the cysts, which were 3-35 mm in diameter. All patients had typical renal stigmata of APKD. None had cysts elsewhere, except one patient with hepatic cysts. Postmortem examination in one patient confirmed the seminal vesicle cysts as well as APKD. It is likely that a basement membrane defect allows cyst formation in multiple organs, presumably including the seminal vesicles. Because of the association of seminal vesicle cysts with ipsilateral urogenital anomalies, and because only 60% of patients with APKD have a relevant familial history, the kidneys of patients with cross-sectional imaging evidence of seminal vesicle cysts should also be studied.

Male genital tract malformations associated with ipsilateral renal agenesis: Sonographic findings

Ten male patients with ultrasonographic evidence of an internal genital anomaly associated with ipsilateral renal agenesis are presented. The abnormalities consist of seminal vesicle agenesis in 4, seminal vesicle cyst in 3, Wolffian duct remnant in 2, and Mullerian duct remnant in 1. Such developmental defects are due to a primary anomaly of the mesonephros. Due to its capability of visualizing the lumbar and pelvic regions simultaneously, ultrasonography appears to be the first-choice imaging modality for the screening of such genitourinary developmental malformations.

Cysts of the Prostate, Seminal Vesicles and Diverticulum of the Ejaculatory Ducts

The close proximity of the prostate, vas deferens, seminal vesicles and ejaculatory ducts are a diagnostic challenge to the cysts located in that region. Three patients with diverticulum of the ejaculatory ducts, 2 with prostate cysts and 1 patient with seminal vesicle cyst are presented. Transrectal ultrasound, computed tomography and magnetic resonance imaging together with aspiration of the cyst establish diagnosis and probably prevent unnecessary exploration.

Congenital cystic disease of the seminal vesicle.

Thirteen cases of congenital seminal vesicle cysts with pathologic correlation were diagnosed between 1970 and 1988. Twelve of the 13 patients had ipsilateral renal anomalies. Intravenous urography, performed in 11 of the 13 patients, demonstrated associated renal anomalies. Computed tomography, performed in nine of the 13 patients, demonstrated associated renal anomalies and displayed the cystic seminal vesicles. Transabdominal or endorectal ultrasonography, performed in eight patients, allowed characterization of the seminal vesicle masses as cystic. Magnetic resonance imaging, performed in three of the 13 patients, accurately demonstrated dilated ejaculatory ducts into which ectopic ureters inserted. The fluid in the seminal vesicle cysts had an increased signal intensity on T1- and T2-weighted sequences. Seminal vesiculographic study demonstrated anomalous communications with the seminal tract. Cystic disease of the seminal vesicles can be either congenital or acquired; congenital cysts are associated with anomalies of the ipsilateral mesonephric duct.

Seminal vesicles. Imaging and intervention using transrectal ultrasound.

The seminal vesicles are difficult to evaluate clinically. Transrectal ultrasound (TRUS) has only recently allowed adequate assessment of these structures and their disorders. As the use of TRUS increases, radiologists must familiarize themselves with diseases of the seminal vesicles and the normal and abnormal appearance at ultrasound. This paper presents four cases illustrating the uncommon disorders that TRUS can demonstrate in the seminal vesicles: ectopic ureter entering the seminal vesicle, symmetrically enlarged seminal vesicles with male infertility, a pelvic arteriovenous malformation mimicking a seminal vesicle cyst, and tuberculosis. In two patients, TRUS was used to guide needle aspiration of seminal vesicle contents safely and to inject contrast for radiography.