How to detect seminal vesiculitis? Semen examination is very important.

Patients with seminal vesiculitis will experience enlarged seminal vesicles, abdominal discomfort, fatigue, hematospermia, frequent urination, urgency and pain during urination. If the seminal vesiculitis persists for a long time, it will affect sexual function. Timely examination is required. Semen examination, rectal B-ultrasound examination, and CT examination can all detect it in time.

1. Semen examination:

(1) Bacterial culture

Even if only semen cytology or bacterial culture is positive, it cannot be confirmed that it is seminal vesiculitis. However, if the prostate massage fluid is sterile in culture and there are a large number of bacteria in the semen or the bacteria are different from those in the prostate fluid, it can be diagnosed as bacterial seminal vesiculitis. The culture value of the seminal tract fluid obtained by aspiration during spermatography or the midstream urine obtained after seminal vesicle perfusion is greater.

(2) The normal value of fructose in refined plasma is 0.87-3.95 g/L. Long-term chronic seminal vesiculitis can cause the fructose content to decrease or even become negative.

2. Transrectal ultrasound examination

In patients with a short course of illness, the seminal vesicle may become enlarged and fusiform, with an elliptical distal end. The cyst wall may become rough and thickened, and the cyst may contain dense, chaotic small dot-like echoes. In patients with a long course of illness of several years, the seminal vesicle may become smaller.

3. CT

The morphology inside the seminal vesicle cannot be displayed. When inflammation blocks the ejaculatory duct, CT can show dilation of the duct lumen, some of which appear as uneven low-density cystic dilation. Chronic inflammation causes fibrosis of the seminal vesicle, and the seminal vesicle may become smaller.

4. Seminal vesiculography

Currently, vasography is mainly performed by directly puncturing the vas deferens through the scrotal skin. The following can be seen on dynamic vasography and instant and extended films of vasography:

(1) Exudate: It is more common in the abdomen of the canal, with cloudy changes around it, blurry images inside the tube, or unsatisfactory imaging due to inflammatory exudate retained in the lumen.

(2) Stenosis: Different manifestations are caused by different locations. When the abdomen of the pot is narrow, it can cause dilation of the vas deferens. When the seminal vesicle duct is narrow, the seminal vesicle duct near the bottom cannot be shown, and delayed imaging can show the seminal vesicle duct near the bottom. When the ejaculatory duct is narrow, the sperm duct on that side can be seen to be dilated, and emptying is delayed.

(3) Dilation: It can be a direct manifestation of inflammation or post-obstruction dilation. The former is often localized cystic dilation, similar to a cyst; the latter is often uniform dilation or combined with localized cystic dilation.

(4) Occlusion: If the seminal vesicle duct is occluded, the seminal vesicle on that side will not be visible. When the ejaculatory duct is occluded, in addition to the dilation of the seminal tract on the affected side, the contrast agent cannot enter the posterior urethra and bladder. After stopping the injection, the contrast agent and the contents of the seminal vesicle can be seen to flow back into the syringe. Delayed imaging may sometimes still show contrast agent remaining in the seminal tract for more than 16 days.