Index
The vesicles lie laterally (from the side) from the vas deferens, between the rectum and the bottom of the bladder.
The seminal vesicles are the formations located in the immediate proximity of a prostate and that have a kind of twisted tube that in the straightened type has a length of up to 12 cm, and straightened almost 2 times less.
Each seminal vesicle produces a liquid part of sperm that is released through the ejaculatory duct at the base of the seminal tubercle in the prostate part of the urethra.
Vesiculitis pathogens
The causative agents of vesiculitis in the vast majority of cases were gonococci (up to 80%), but with the introduction of antibiotic drugs in medical practice, their specific gravity decreased significantly, since gonorrhea in men is rarely very currently violent.
Modern spermatocystitis is most often caused by streptococci, staphylococci, E. coli, and some other microorganisms. Occasionally – Mycobacterium tuberculosis, if there is urogenital tuberculosis.
Sometimes the main cause of the development of vesiculitis is stagnation in the small pelvis (for example, stagnation of blood in the veins of the pelvis) or directly in the seminal vesicles (for example, when the flow of contents of seminal vesicles is disturbed for an extended period).
Causes
- Stagnant phenomena with an enlargement (hypertrophy) of the prostate.
- Sexual excesses and perversions, leading to frequent and prolonged overfilling of pelvic organs with blood.
- Periodic microtrauma of the perineum as a result of cycling, horseback riding, etc.
- Diseases of an inflammatory nature of neighboring organs: for example, prostatitis , urethritis, cystitis.
- Infection in seminal vesicles of distant organs through lymphatic or blood vessels, and also through the wall of the rectum with diseases of this organ.
Classification
According to the changes observed as a result of inflammation in the seminal vesicles, vesiculitis is distinguished:
- Catarrhal (superficial).
- Deep.
- Paravezulitis.
- Seminal vesicle empyema.
Catarrhal spermatocystitis is characterized by redness (hyperemia) of the mucous membrane, its swelling, slight shedding, and damage to the lining epithelium.
In the seminal vesicle there is a mucopurulent content, often with a small mixture of blood, and the vial itself is stretched and slightly enlarged in size.
The inflammatory process with deep vesicles affects the deeper layers, spreading to the submucosa and the muscular layer of the seminal vesicles.
A seminal vesicle empyema occurs when, in the case of deep spermatocystitis, the pyogenic microflora plays the most important role, and the vesicles fill with a large amount of purulent contents.
Paraesiculitis develops as a complication of deep vesiculitis, when the inflammatory process goes beyond the vesicles and spreads to the surrounding fiber.
Deep vesiculitis in some cases can lead to atrophic cirrhosis of the bullae.
Symptoms
Acute vesiculitis develops for a short time.
The following main symptoms of the disease:
- A feeling of heaviness or pain in the rectum and perineum.
- Irradiation of lumbar pain, bladder, scrotum.
- The intensification of painful sensations at the end of a defecation or act of urination.
- Frequent urination, accompanied by a burning sensation.
- In some cases, terminal hematuria (presence of blood at the end of the act of urination), an urgent need to urinate.
- Increased sexual excitability.
- Frequent pollution and erections.
- During ejaculation: burning pain, pain in the penis, head, prostate.
- Presence in the seminal fluid of pus, blood (in this case, ejaculation looks like currant jelly).
- Temperature rise to 39 ° C or more.
Symptoms that accompany a high fever
- General weakness
- Increased discomfort.
- Decreased appetite.
- Pain in the bones and joints.
- Headache.
- Sickness.
Acute vesiculitis can heal spontaneously or go into a chronic form (the latter is seen much more frequently).
In general, the picture of acute vesiculitis resembles that of acute prostatitis, so this condition requires a mandatory medical examination.
In general, chronic vesiculitis is less violent than acute. Symptoms of inflammation are less pronounced, but in this case there are signs of atrophy of the seminal vesicles and a gradual loss of their function.
Characteristic symptoms of chronic vesiculitis
- Weak erections.
- Sperm expiration (spermatorrhea).
- Premature and painful ejaculation.
- Periodic, aching, aching pains in the suprapubic region, rectum, perineum, sacrum.
- Increased pain during urination or defecation.
- Presence of traces of blood in the seminal fluid.
If obliteration of the ejaculatory duct occurs, a decrease in the number of sperm is observed when examining the spermogram.
In some cases, the symptoms in the chronic form of vesiculitis are almost non-existent, and then they speak of the asymptomatic flow of chronic spermatocystitis.
Complications
Acute and chronic vesiculitis can lead to the following complications:
- Thrombophlebitis of major venous plexuses (eg, prostate, bladder).
- Opening into the urethra, abdominal cavity, or rectum of the abscess followed by the development of peritonitis or fistula formation.
- The appearance of chronic epididymitis or urethritis.
- Development of male infertility.
- Thrombophlebitis of the urinary or venous plexus.
This complication often leads to the development of stagnant phenomena.
As a general rule, the following symptoms are typical:
- Malaise, aching pain in the perineum.
- Increased unpleasant sensations after prolonged position, prolonged walking.
- Allocation of the main amount of urine at night.
- Painful or difficult urination
- Alcohol intake, sexual excesses, prolonged abstinence lead to a worsening of the process.
If thrombophlebitis develops abruptly, there is an increase in pain, dysoric disorders, a sudden increase in temperature up to 40 ° C. Stagnation phenomena in the venous plexus contribute to reducing local immunity and the development of infections: for example , the appearance of prostatitis, urethritis and cystitis.
Abscess autopsy
The abscess can enter the abdominal cavity. In this case, there is a serious condition of acute peritonitis, accompanied by intoxication and violation of the general condition of the patient.
When a fistula is formed in the rectum, it can be observed that the stool is thrown into the seminal vesicles or around the cellulose, which is accompanied by an increase in inflammatory phenomena, a deterioration in the general condition of the patient.
Epididimitis Yauhtecatl
It can be practically asymptomatic or be characterized by painful sensations in the area of the testicles when walking, an increase in the appendages and their densification.
Urethritis
Inflammation of the urethra is characterized by burning, pain, or cuts when urinating. There are also secretions from the urethra (especially after a night’s sleep) with an unpleasant odor of a mucus-purulent nature, sometimes with an admixture of blood.
However, in some cases, the symptoms of urethritis are practically absent (asymptomatic course).
Sterility
Infertility with vesiculitis develops in cases where obliteration of the lumen of the ejaculatory duct occurs. With partial obliteration, there may be a decrease in the total number of sperm in the semen.
Diagnosis
The diagnosis of spermatocystitis is based on the characteristic symptoms of acute or chronic vesiculitis, as well as on urological examination.
To diagnose this disease, it is necessary to conduct a mandatory examination of the prostate through the rectum. The study is performed with a full bladder in the position of the patient lying with the knees bent and pressed towards the abdomen on the right side.
In the normal state, the seminal vesicle is not palpable. However, if there is acute vesiculitis, the doctor can identify the following symptoms on a rectal exam:
Spermatocystitis – insignificant swelling and pain in the field of the seminal vesicles.
Deep vesiculitis : the seminal vesicles are accessible by palpation and are determined above the upper edge of the prostate, and also closer to the lateral wall of the rectum in the form of dense, elastic and painful formations of a rounded shape from one or both sides of the the prostate gland.
Empyema : Seminal vesicles are defined as a painful, elastic sausage- or pear-shaped formation.
Pravesiculitis : Instead of seminal vesicles, a dense, diffuse, and painful infiltrate is palpable, spreading laterally. The contours of the seminal vesicles in this case are not determined.
The microscopic and bacteriological study of the secretion of the vesicles plays an important role in the diagnosis of spermatocystitis.
For the purposes of the differential diagnosis of vesiculitis, the urologist may prescribe the following types of additional tests:
- Ultrasound of the pelvic organs – with its help, tumors, cysts and other organs of the genitourinary system are diagnosed with tuberculosis and some other diseases.
- Vesychology: also helps in the diagnosis of various diseases of the seminal vesicles and prostate. It is an x-ray study that uses contrast.
- The Wasserman reaction: allows to reveal syphilis, in which the seminal vesicles can also increase in volume.
In addition, if necessary and the presence of concomitant diseases are identified: a general analysis of urine, blood, examination of the hormonal profile, etc.
Treatment
Acute vesiculitis is treated in a urology department. Assign a semi-postal regimen, an easy and smooth diet.
Thermal procedures
- Hot sessile baths – for 15-20 minutes. 2 or 3 times during the day.
- Warmer in the perineal region.
- Microclysters with hot water (40 ° C) with the addition of 0.5-1 g of antipyrine 2 or 3 times a day. The patient keeps warm water in the rectum for 10-30 minutes, then releases it again.
Medicines
- Anesthetics
- Antibiotic therapy.
- Vitamins A, C, group B (B 1,2).
After the relief of acute inflammation by massage, the secretion of the seminal vesicles is obtained and a microscopic and bacteriological examination is carried out (in the case of acute vesicles, such massage is contraindicated).
The main methods of treatment of chronic vesiculitis
- Urological massage.
- Physiotherapy (diathermy, mud therapy, paraffin treatment).
- Silver nitrate instillation 0.25-0.5% in the urethra (its posterior part).
- Introduction of antibacterial drugs directly into the seminal vesicles.
- Surgical methods of treatment (eg, vesiculolectomy).
In general, with all the necessary recommendations, the treatment of vesiculitis proceeds successfully and ends in recovery.
Prevention
Prevention of vesiculitis is the early and rational treatment of the main focus of infection (including gonorrhea, syphilis, etc.), diet and refusal to drink alcohol.
It is also necessary to avoid microtraumas and normalize sexual life, not allowing too long periods of abstinence or sexual excesses.
