Seminal vesicle cyst?

In life, many people think of cancer when talking about cysts. In fact, cysts are divided into many types. Cysts can be benign or malignant. Cysts can also be congenital or acquired. If there are no obvious symptoms of a seminal vesicle cyst, it is generally a congenital lesion. If it is a secondary seminal vesicle cyst, the body will have hematospermia. If the cyst is too large, it will affect the patient's urination. The treatment of cysts must be treated under the guidance of a doctor.

Congenital seminal vesicle cysts can be divided into two types according to their origin: the seminal vesicle itself and the abnormal development of the mesonephric ducts during the embryonic period. During the development of male embryos, the paramesonephric ducts, mesonephric ducts and some remaining mesonephric tubules evolve into useful structures or degenerate into useless structures. Some of them often form some tubular or vesicular residual structures that remain in the tissues of the testis, epididymis or seminal vesicles. Some of them form cysts, while others form cysts due to abnormal proliferation caused by certain factors in the long-term life after birth. Recent literature reports that the occurrence of seminal vesicle cysts is related to autosomal dominant adult polycystic kidney disease. Some people (Varney 1954) believe that this type of cyst is equivalent to a shortened ureter or a cyst-like diverticulum developed from a residual ureteric bud, so some people call it "pseudo-seminal vesicle cyst".

Clinical manifestations

Symptoms of this disease include hematospermia, perineal pain after ejaculation, bloody urethral discharge, hematuria, frequent urination, and dysuria. In larger cases, there may be abdominal pain and urination difficulties. Rectal digital examination or bimanual examination may touch the cystic tumor.

Seminal vesicle cysts are common in young and middle-aged people. Common symptoms are hematospermia, hematuria and ejaculation disorders. Hematuria can be whole-course hematuria, or it can be initial or final hematuria, and can be accompanied by bladder irritation symptoms such as frequent urination and urgency. When the cyst is larger, discomfort in the lower abdomen, lumbar sacral region and perineum may occur. Some cases may be complicated by seminal vesicle stones. Epididymitis or prostatitis induced by seminal vesicle cysts can recur repeatedly. Some patients have no obvious symptoms.

Check

B-mode ultrasound or CT scan can not only show the outline of the posterior bladder structure, but also distinguish between solid and cystic structures. On ultrasound images, seminal vesicle cysts often occur in one side of the seminal vesicle, appearing as an echo-free area, with smooth and thin cystic walls and enhanced echo of the posterior wall. On CT images, cystic thick-walled lesions can be seen in the seminal vesicle, and their density depends on the protein content in the cystic fluid. The wall can be smooth or irregular, and the cyst wall can be enhanced after enhanced scanning, while there is no enhancement inside the cyst, which may be accompanied by abnormal or absent kidney morphology on one side. Seminal vesiculography is an important means of diagnosis.

Diagnosis

Based on clinical symptoms and rectal examination, larger cysts of the seminal vesicle are often misdiagnosed as urine retention or a full bladder, but no urine can be collected after inserting a urinary catheter. Rectal examination and abdominal double examination can palpate a mass above the prostate.

Differential diagnosis

Seminal vesicle cysts need to be distinguished from seminal vesicle cancer. Seminal vesicle cancer is extremely rare and most cases arise secondary to the prostate, bladder, rectum, or nearby tissues. Kato Tetsuro et al. believe that cysts may be combined with malignant tumors and should be carefully distinguished. During rectal examination, hard nodules and irregular fusiform masses may be palpated. Cystoscopy may reveal that the entire bladder base and trigone are elevated, resulting in bladder neck obstruction and primary symptoms. Seminal vesiculography can clarify the relationship between tumors and seminal vesicles.

This disease also needs to be differentiated from prostatic cysts, hydatid cysts, bladder diverticulum and seminal vesiculitis. The latter can be differentiated by transrectal diagnosis, seminal vesiculography and cystoscopy.

treatment

Conservative treatment is mainly used for patients with small cysts, mild symptoms and young patients. Regular massage and regular follow-up visits are recommended. If the cyst is larger than 2.5 cm and the symptoms are obvious, surgical treatment can be considered. The cyst can be drained through the perineum. If there is ectopic ureteral orifice, nephroureterectomy can be performed. If the seminal vesicle is enlarged and the symptoms are obvious, it can be surgically removed.