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Vesiculitis: Symptoms and Treatment


Vesiculitis Vesiculitis, or spermatocystitis, is a disease that is characterized by inflammation of the seminal vesicles. It is usually observed in men after undergoing any infectious-inflammatory process and occurs in about a third of men after 35 years.

What are the seminal vesicles

The seminal vesicles are formations located in the immediate vicinity of the prostate and having the appearance of a convoluted tube, which in the straightened form has a length of up to 12 cm, and in the unfolded state it is almost 2 times smaller. The bubbles lie laterally (laterally) from the vas deferens, between the rectum and the bottom of the bladder.

Each seminal vesicle produces a liquid portion of the sperm, which is released through the vas deferens at the base of the seed tubercle in the prostate portion of the urethra.

Vesiculitis pathogens

In the overwhelming majority of cases, vesiculitis pathogens were previously gonococci (up to 80%); however, with the introduction of antibacterial drugs into medical practice, their proportion decreased significantly, since gonorrhea in men is rarely too rapid now.

Modern spermatocystitis is increasingly caused by streptococcus, staphylococcus, Escherichia coli and some other microorganisms. Occasionally - Mycobacterium tuberculosis, if there is urogenital tuberculosis .

Sometimes the leading cause of vesiculitis development is stagnation in the pelvis (for example, blood stagnation in the pelvic veins) or directly in the seminal vesicles (for example, when the outflow of contents from the seminal vesicles is disturbed for a long time).

The reasons

  1. Congestion with an increase in (hypertrophy) of the prostate.
  2. Sexual excesses and perversions, leading to frequent and prolonged overflow with blood of the pelvic organs.
  3. Periodic microtrauma of the perineum as a result of cycling, horse riding, etc.
  4. Diseases of the inflammatory nature of neighboring organs: for example, prostatitis, urethritis, cystitis .
  5. Infection into the seminal vesicles from distant organs through lymphatic or blood vessels, as well as through the wall of the rectum in diseases of the organ.


According to the changes observed as a result of inflammation in the seminal vesicles, vesiculitis is distinguished:

  • catarrhal (superficial),
  • deep,
  • paravesiculitis,
  • empyema seminal vesicle.

Catarrhal spermatocystitis is characterized by redness (hyperemia) of the mucous membrane, its edema, slight desquamation and damage to the lining epithelium. In the seminal vesicle is mucopurulent contents, often with a small admixture of blood, and the vesicle is stretched and slightly increased in size.

The inflammatory process in deep vesicles affects the deeper layers, spreading to the submucosa and muscle layer of the seminal vesicles. In this case, the bubbles are also enlarged, hyperemic, edematous. Their walls are dense, and in the lumen - a large amount of serous secretion mixed with pus.

Empyema of the seminal vesicle occurs when, in the event of the occurrence of deep spermatocystitis, the pyogenic microflora plays the greatest role, and the vesicles themselves are filled with large amounts of purulent contents.

Paravesiculitis develops as a complication of deep vesiculitis, when the inflammatory process goes beyond the bubbles and extends to the surrounding fiber.

Deep vesiculitis in some cases can lead to atrophic cirrhosis of the bubbles.

Vesiculitis symptoms

Acute Spermatocystitis

Acute vesiculitis develops in a short time and is characterized by the following main symptoms of the disease:

  • feeling of heaviness or pain in the rectum and perineum;
  • Irradiation of pain in the lower back, bladder, scrotum;
  • increased pain by the end of defecation or urination;
  • frequent urination, accompanied by burning sensation;
  • in some cases, there are terminal hematuria (the presence of blood at the end of the act of urination), imperative urination to urinate;
  • increased sexual excitability;
  • frequent pollutions and erections;
  • during ejaculation - burning pains radiating to the penis, its head, prostate gland;
  • the presence of pus in the seminal fluid, blood (in this case, the ejaculate resembles currant jelly);
  • temperature increase up to 39 ° C and more;
  • symptoms associated with high fever: general weakness, increased malaise, loss of appetite, pain in bones and joints, headache, nausea.

Acute spermatocystitis in young males proceeds most rapidly.

Acute vesiculitis can be cured spontaneously or become chronic (the latter is observed much more often). In general, the picture of an acute vesiculitis resembles that of acute prostatitis, therefore this condition requires an obligatory medical examination.

Chronic spermatocystitis

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 the gradual loss of their function.

Characteristic symptoms of chronic vesiculitis:

  • weak erections;
  • sperm discharge (spermatorrhea);
  • premature and painful ejaculation;
  • unsharp, aching recurrent pain in the suprapubic region, rectum, perineum, sacrum;
  • increased pain during urination or bowel movements;
  • traces of blood in seminal fluid.

If there was obliteration of the vas deferens, then in the study of sperm, a decrease in the number of sperm is observed.

In some cases, the symptoms in the chronic form of vesiculitis are practically absent, then they speak of an asymptomatic course of chronic spermatocystitis.

Vesiculitis Complications

Acute and chronic vesiculitis can lead to the following complications:

  • thrombophlebitis of important venous plexuses (for example, prostatic, vesical);
  • an autopsy into the urethra, abdominal cavity or rectum of the abscess with the subsequent development of peritonitis or the formation of fistulas;
  • the occurrence of chronic epididymitis or urethritis;
  • development of male infertility.

Thrombophlebitis of the urinary bladder or prostate venous plexus

This complication often leads to a violation of the outflow of blood and the subsequent development of phenomena of a stagnant nature. As a rule, the following symptoms are characteristic:

  • discomfort, aching pain in the perineum;
  • increased discomfort after a long stay, long walk;
  • excretion of the main amount of urine at night;
  • painful or difficult urination.

Alcohol intake, sexual excesses, prolonged abstinence lead to aggravation of the process.

If thrombophlebitis develops acutely, then there is an increase in pain, dysuric disorders, a sudden rise in temperature to 40 ° C. Congestion in the venous plexuses contribute to the reduction of local immunity and the development of infections: for example, the occurrence of prostatitis, urethritis, cystitis.

Opening the abscess

An abscess can break into the abdominal cavity. In this case, there is a serious condition of acute peritonitis, accompanied by intoxication and violation of the patient’s general condition.

With the formation of a fistula in the rectum, there may be a reflux of fecal masses into the seminal vesicles or the surrounding fiber, which is accompanied by an increase in inflammatory phenomena, and a deterioration in the patient’s general condition. In such cases, a new microflora may appear in the ejaculate, which is characteristic of the rectum, and not of the genitourinary system.

Chronic epididymitis

It may be almost asymptomatic or may be characterized by painful sensations in the testicles when walking, an increase in appendages and their compaction.


Inflammation of the urethra is characterized by burning, pain, or cutting when urinating. There are also discharge from the urethra (especially after a night's sleep) with an unpleasant smell of mucopurulent character, sometimes with blood.

However, in some cases, the symptoms of urethritis are practically absent (asymptomatic).


Infertility with vesiculitis develops in cases where there is obliteration of the lumen of the ejaculatory duct. With partial obliteration, a decrease in the total sperm count in the semen may be observed.

Vesiculitis Diagnosis

The doctor makes a diagnosis of spermatocystitis on the basis of the characteristic symptoms of acute or chronic vesiculitis, as well as a urological examination.

To diagnose this disease, it is necessary to conduct a mandatory digital examination of the prostate through the rectum. The study is performed with a filled bladder in the position of the patient lying with knees bent and pressed to the stomach on the right side.

In the normal state, the seminal vesicle is not palpable. However, if acute vesiculitis occurs, the doctor may identify the following symptoms during a rectal examination:

  • Catarrhal spermatocystitis is a slight swelling and tenderness in the region of the seminal vesicles.
  • Deep vesiculitis - the seminal vesicles are accessible by palpation and are determined above the upper edge of the prostate, as well as closer to the lateral wall of the rectum in the form of dense, elastic, painful round formations on one or both sides of the prostate gland.
  • Empyema - seminal vesicles are defined as a painful, springy formation of a sausage or pear shape.
  • Pravrasiculitis - instead of the seminal vesicles, a dense, diffuse and painful infiltrate is palpated, which spreads to the sides. The contours of the seminal vesicles in this case are not defined.

An important role in the diagnosis of spermatocystitis is played by microscopic and bacteriological examination of the secret of the bubbles. In vesiculitis, the secret may contain: leukocytes, hematoidin crystals, red blood cells, epithelial cells, spermatozoa.

For the purpose of differential diagnosis of a vesiculitis, the urologist may prescribe the following additional types of examination:

  • Ultrasound of the pelvic organs . It helps to detect tumors, cysts, damage to other organs of the urogenital system in tuberculosis and some other diseases.
  • Vesiculography . Also helps in the diagnosis of various diseases of the seminal vesicles and prostate. It is an x-ray with contrast.
  • Wasserman reaction. Allows you to identify syphilis , in which the seminal vesicles can also increase in volume.

Also, if necessary, and the presence of concomitant diseases are assigned: urinalysis, blood analysis, the study of hormonal profile, etc.

Vesiculitis treatment

Acute vesiculitis is treated in the urological department. Assigned to semi-bed mode, light, gentle diet.

Heat treatments:

  • hot sitz baths - 15–20 min. 2 or 3 times a day;
  • hot-water bottle on the crotch area;
  • microclysters with hot water (40 ° C) with the addition of 0.5–1 g of antipyrine 2 or 3 times a day. The patient holds hot water in the rectum for 10–30 minutes, then releases it back.


  • at sexual arousal - containing bromine;
  • for pain - candles with ergot, painkillers;
  • antibiotic therapy;
  • vitamins A, C, group B (B 1,2 ).

After the relief of acute inflammation by massage, the secret of the seminal vesicles is obtained and microscopic and bacteriological examination is performed (with an acute vesicle, such a massage is contraindicated).

The main methods of treatment of chronic vesiculitis:

  • urological massage;
  • physiotherapy (diathermy, mud therapy, paraffin);
  • silver nitrate instillation of 0.25–0.5% into the urethra (its posterior part);
  • the introduction of antibacterial drugs directly into the seminal vesicles;
  • surgical treatments (for example, vesiculectomy).

In chronic vesiculitis mud resorts are shown: Essentuki, Saki, Pyatigorsk.

In general, with the implementation of all the necessary recommendations, the treatment of vesiculitis is successful and ends in recovery.


Prophylaxis of vesiculitis consists in early and rational treatment of the main focus of infection (including gonorrhea, syphilis, etc.), dieting, refusal to drink alcohol. It is also necessary to avoid microtraumas and normalize sex life, avoiding periods of too long abstinence or sexual excesses.

| 13 March 2014 | | 5,868 | Male diseases
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