Vasoseminal vesiculography is becoming more and more valuable to the diagnosis of seminal ductal system diseases. Vasography can be performed by either trans-scrotal injection into the vas deferens, or transperineal injection into seminal vesicle, or retrograde insertion of a catheter into the opening of the ejaculatory duct. A good knowledge of the indications and proper judgement of the X-ray signs may significantly improve the diagnosis and treatment of the diseases of the seminal vesicle and ductal system.
Ejaculatory Ducts ; Genital Diseases, Male ; diagnostic imaging ; Humans ; Male ; Radiography ; Seminal Vesicles ; diagnostic imaging

Adult ; Aged ; Hemospermia ; diagnostic imaging ; therapy ; Humans ; Male ; Middle Aged ; Punctures ; Rectum ; diagnostic imaging ; Seminal Vesicles ; Therapeutic Irrigation ; Ultrasonography

OBJECTIVETo explore the correlation between ectasia of the rete testis (ERT) and the volume of seminal vesicle cyst (SVC) in the epididymal head by ultrasonography.

METHODSThis study included 36 cases of ERT diagnosed by color Doppler ultrasonography and complicated with SVC in the epididymal head (case group), and another 44 SVC cases without ERT (control group), all confirmed by surgery or fine-needle aspiration. We analyzed the differences in nationality, age, volume of SVC and resistance index of the afferent artery in the diseased testis between the two groups of patients.

RESULTSNo statistically significant differences were observed between Chinese Uighurs and Hans (P > 0.05), nor in the mean age between the two groups of patients (P > 0.05). There were significant differences in the mean volume of SVC between the case and control groups ([2.081 +/- 1.147] cm3 vs [1.009 +/- 0.848 ] cm3, P < 0.01), but not in the resistance index of the afferent artery in the diseased testis (0.644 +/- 0.099 vs 0.608 +/- 0.116, P > 0.05).

CONCLUSIONThe volume of seminal vesicle cyst in the epididymal head plays a significant role in the formation of ectasia of the rete testis.

Adult ; Aged ; Case-Control Studies ; Epididymis ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Rete Testis ; diagnostic imaging ; Seminal Vesicles ; diagnostic imaging ; Testicular Diseases ; diagnostic imaging ; Ultrasonography, Doppler, Color

OBJECTIVETo evaluate the value of percutaneous vasography in the diagnosis of the disorders of the seminal duct system.

METHODSPercutaneous vasography was performed successfully in 63 male patients (24 cases of infertility, and 21 hemospermia, 16 chronic prostatitis, and prostate carcinoma) from November 1974 to December 2003.

RESULTSVasography revealed abnormal ducts in 28 and disorders in 38 (60.3%), including 8 cases of sterility, 13 seminal vesiculitis, 16 chronic prostatitis 5 seminal vesical cyst, and 2 prostate carcinoma.

CONCLUSIONPercutaneous vasography is an effective method to identify diseases of the seminal vesical and ductal system.

Adult ; Aged ; Ejaculatory Ducts ; diagnostic imaging ; Genital Diseases, Male ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Radiography ; methods ; Seminal Vesicles ; diagnostic imaging ; Vas Deferens ; diagnostic imaging

OBJECTIVETo investigate the ultrasonographic features of obstructive azoospermia and to evaluate transrectal ultrasonography in the diagnosis of the disease.

METHODSWe performed transrectal ultrasonography for 248 patients with obstructive azoospermia, observed the sonographic features of the prostate gland, seminal vesicle and ejaculatory duct.

RESULTSThe average volume of the prostate gland of the studied group was 13.2 ml. A total of 111 cases showed normal sonographic features, 39 cases bilateral seminal vesicle defect, 33 cases bilateral seminal vesicle aplasia, 23 cases unilateral seminal vesicle defect and contralateral seminal vesicle aplasia, 28 cases bilateral and 14 cases unilateral seminal vesicle dilatation. Of the 42 cases of seminal vesicle dilatation, 18 had ejaculatory duct dilatation and 17 had cysts in the midline of the prostate.

CONCLUSIONObstructive azoospermia varies in kind. Transrectal ultrasonography can reveal the details of the prostate, seminal vesicle and ejaculatory duct and help to classify obstructive azoospermia and determine the location of the lesion.

Adult ; Azoospermia ; diagnostic imaging ; Ejaculatory Ducts ; diagnostic imaging ; Humans ; Male ; Middle Aged ; Posture ; Prostate ; diagnostic imaging ; Rectum ; Seminal Vesicles ; diagnostic imaging ; Ultrasonography

ObjectiveTo summarize the experience in the diagnosis and treatment of refractory hematospermia and ejaculatory duct obstruction by seminal vesiculoscopy.

METHODSWe retrospectively analyzed the clinical data about 42 cases of refractory hematospermia and 6 cases of ejaculatory duct obstruction with azoospermia. We investigated the diagnosis, treatment, and prognosis of the diseases.

RESULTSAll the patients underwent pelvic MRI and seminal vesiculoscopy. MRI for the 42 refractory hematospermia patients showed that 21 (50.0%) had cystic dilatation in the uni- or bilateral seminal vesicles, 25 (59.5%) had abnormal internal signal intensity in the uni- or bilateral seminal vesicles, 12 (28.6%) had both the problems above, and 4 (9.52%) had no obvious abnormality in the seminal vesicle area. The bilateral seminal vesicles were <1 cm in width in 3 of the 6 cases of ejaculatory duct obstruction, and obviously enlarged in the other 3, but without abnormal internal signals. No recurrence was found during the 3－36 months follow-up.

CONCLUSIONSThe history and physical examination play important roles in the diagnosis of refractory hemospermia, and MRI is more valuable than TRUS in the diagnosis of seminal vesicle diseases. Seminal vesiculoscopy is an effective option for the management of persistent hematospermia and ejaculatory duct obstruction.

Azoospermia ; Ejaculatory Ducts ; diagnostic imaging ; physiopathology ; Endoscopy ; methods ; Hemospermia ; diagnostic imaging ; Humans ; Magnetic Resonance Imaging ; Male ; Recurrence ; Retrospective Studies ; Seminal Vesicles ; diagnostic imaging ; physiopathology

Objective: To explore the clinical diagnosis and treatment of seminal vesicle cyst (SVC) associated with ipsilateral renal agenesis (Zinner syndrome) in order to promote the understanding of the disease. METHODS: We retrospectively analyzed the clinical data about 1 case ofZinner syndrome diagnosed and treated in our hospital and reviewed the literature related to this disease in domestic and foreign authoritative databases. RESULTS: The patient was a 23-year-old male, diagnosed with Zinner syndrome, treated bytransrectal aspiration of SVC, and discharged from hospital 3 days postoperatively. Follow-upat 6 months after discharge found that the patient no longer felt perineal discomfort in the endstage of urination, but transrectal ultrasonography of the prostate revealedthe samevolume of fluid in the left seminal vesicles as before,which indicated recurrence. CONCLUSIONS SVC associated with ipsilateral renal agenesis can be considered asZinner syndrome. Transrectal aspiration of SVCcan relieve the local symptoms of the patient but relapse may easilyoccur. Therefore it is not recommended as the first-choice treatment of the disease.
Cysts ; diagnostic imaging ; therapy ; Genital Diseases, Male ; diagnostic imaging ; therapy ; Humans ; Male ; Perineum ; Recurrence ; Retrospective Studies ; Seminal Vesicles ; diagnostic imaging ; Solitary Kidney ; complications ; Syndrome ; Ultrasonography ; Young Adult

Seminal vesiculoscopy is a new technology in uro-andrology developed in recent 10 years, which is a set of clinical operational techniques for observing the ejaculatory duct, seminal vesicle, ampullar region of the vas deferens and their surrounding structure, determining the cause, location and degree of the disease, and accomplishing such treatment procedures as irrigation, resection, incision, fulguration, hemostasis, expansion, drainage, and removal of hematocele, stones or obstruction in the distal seminal duct region. Therefore, it is not only an etiologically diagnostic technique, but also a minimally invasive surgical approach to the management of common diseases of the distal seminal duct region. Seminal vesiculoscopy has irreplaceable advantages of safety, effectiveness, minimal invasiveness, rapid recovery, and few complications.
Calculi ; diagnostic imaging ; surgery ; Drainage ; Ejaculatory Ducts ; diagnostic imaging ; Endoscopy ; methods ; Genital Diseases, Male ; diagnostic imaging ; surgery ; Hematocele ; diagnostic imaging ; surgery ; Humans ; Male ; Minimally Invasive Surgical Procedures ; Seminal Vesicles ; diagnostic imaging ; Vas Deferens ; diagnostic imaging

Abnormalities, Multiple/diagnostic imaging* ; Adolescent ; Adult ; Cysts/diagnostic imaging* ; Dysuria/etiology* ; Hemospermia/etiology* ; Humans ; Magnetic Resonance Imaging ; Male ; Male Urogenital Diseases/diagnostic imaging* ; Seminal Vesicles/diagnostic imaging* ; Solitary Kidney/diagnostic imaging* ; Syndrome ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo evaluate the long-term efficacy of transrectal ultrasonography (TRUS)-guided transperineal needle aspiration and irrigation for persistent hematospermia.

METHODSIncluded in the study were 12 patients with persistent hematospermia, aged (36.4 +/- 10.8) years, and with a course of the disease of (13.9 +/- 6.4) months. After the expressed prostatic secretion (EPS) by prostatic massage cultured, the patients received TRUS-guided transperineal needle aspiration for seminal vesicle fluid (SVF) for bacteriological examination. For the EPS positive patients, antibiotics were selected according to the drug sensitivity assay and injected into the abnormal seminal vesicle (SV) via TRUS-guided transperineal needle puncture. The treatment was repeated one month later for those still with hematospermia. The patients were followed up every three months.

RESULTSAbnormal images were found in the SV and/or ejaculatory duct in 9 cases, including SV and/or ejaculatory duct dilation, SV wall thickening, calcification or calculi of SV, and müllerian duct cyst. SVF cultures were positive in 7 cases, including 4 cases of methicillin-resistant Staphylococcus aurous (MRSA), 1 case of methicillin-resistant coagulase-negative staphylococcus (MRCNS), 1 case of E. Coli, and 1 case of Proteus mirabili. All the patients were treated by TRUS-guided transperineal injection of certain antibiotics into SV. Ten of them were followed up for (31.4 +/- 5.7) months. Hematospermia disappeared in 3 cases and relapsed at least once in the other 7. The last follow-up showed hematospermia recurrence in 2 cases.

CONCLUSIONTRUS-guided transperineal irrigation of antibiotics into SV is effective to a certain extent for persistent hematospermia.

Adult ; Anti-Bacterial Agents ; administration & dosage ; Follow-Up Studies ; Hemospermia ; diagnostic imaging ; therapy ; Humans ; Male ; Middle Aged ; Rectum ; diagnostic imaging ; Seminal Vesicles ; Suction ; Therapeutic Irrigation ; Treatment Outcome ; Ultrasonography