Vesiculitis (inflammation of the seminal vesicles)
Vesiculitis (from lat. Vesiculitis), or spermocystitis, is a male disease caused by inflammation of one or both of the paired organs of the male urogenital system - seminal vesicles located in the immediate vicinity of the prostate gland.
The first description of this disease was given in 1975 by the founder of pathological anatomy, JB Morgagni.
Causes of vesiculitis
Thus, any diseases of the urethra, prostate and other organs of the genitourinary system, reflect their condition on the seminal vesicles, leading to vesiculitis.
Often infectious and inflammatory diseases cause vesiculitis. it chronic diseases such as prostatitis, orchitis, epidemiitis or urethritis.
The occurrence of vesiculitis occurs when the seminal vesicles are involved in the inflammatory process by organs suffering from the above diseases.
The causative agents of vesiculitis in the body can be sexually transmitted infections: trichomonads, chlamydia, gonococcus and others. Infection occurs by the penetration of infection through the vas deferens into the seminal vesicles.
Vesiculitis is also possible with a general infectious disease of the body: flu, sore throat, osteomyelitis.
In such cases, the infection that led to the underlying disease enters the seminal vesicles along the bloodstream. According to statistics, most often, vesiculitis occurs in men with a chronic form of prostatitis.
The main reasons contributing to the occurrence of vesiculitis include the following:
Types of vesiculitis disease and their symptoms
Vesiculitis is manifested in two forms: acute and chronic. In the vast majority of cases, the disease proceeds in a chronic form.
Both forms are characterized by a number of common signs of disease:
- the occurrence of weakness
- body temperature rises to 37-39 0С,
- there are pains in the groin, its upper part and perineum,
- giving dull pain in the lower back and sacrum.
The pain reaches its peak with a full bladder or during an act of defecation.
When diagnosing a disease without any external manifestations of vesiculitis, they talk about the course of the disease in a latent form.
The acute form of vesiculitis is manifested by sharp pains in the bladder and rectum, in the lower abdomen, above the inguinal region (on one or both sides).
Pain is given to the inguinal, sacral and lower back. Urine tests show characteristic signs of inflammatory processes.
Analysis of seminal fluid contains a high content of red blood cells and white blood cells. Vesiculitis in acute form is accompanied by a sharp increase in body temperature (39 ° C and above) and accompanied by headaches, pain in the joints and muscles, nausea.
The patient urination becomes more frequentlong frequent nightly erections, during bowel movements, the pain intensifies and there is prostatorea - secretion of a viscous mixture of a milky color from the urethra without sperm, blood impurities appear in semen.
Chronic vesiculitis in men is manifested by the same symptoms as its acute formbut expressed in a slightly different nature of the pain. As a rule, with a chronic form of vesiculitis, the pain is aching in nature. It manifests itself intermittently, irregularly, the main foci - the area of the rectum, sacrum, inguinal region, perineum.
Urination becomes frequent, discharge from the urethra appears, spermatorrhea (frequent or constant discharge of sperm from the urethra) occurs, and bloody discharge is clearly visible in the sperm.
Symptoms of vesiculitis are similar to those of chronic prostatitis and are intermittent.
Chronic vesiculitis erections become painful. Arise complications of urinationcaused by infection in the urinary tract.
Erectile function is impaired and serious degenerative changes in the seminal vesicles occur.
Consequently, normal sperm production is disturbed and bilateral chronic epididymitis develops, one of the forms of male infertility. Another complication of chronic vesiculitis is empyema of the seminal vesicles - their filling with liquid pus and stretching of the seminal vesicle.
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What is dangerous vesiculitis?
If vesiculitis is not diagnosed (there is an asymptomatic course!) and not start treatment on time, complications may occur that clearly lead to infertility. Signs of a complication of the disease are a sharp increase in body temperature to 38-40 ° C, deterioration and exacerbation of all signs of vesiculitis.
Empyema develops, seminal vesicles are filled with pus, which requires immediate intervention and subsequent drainage to ensure the outflow of pus.
Such a situation requires immediate hospitalization of the patient and the appointment of the necessary treatment.
With a complication of the disease the risk of infertility is maximum, and the processes leading to it, as a rule, are irreversible. Often, with a hidden course of the disease, vesiculitis is diagnosed during the diagnosis of the causes of infertility.
Despite the fact that vesiculitis currently successfully treated in a hospital under medical supervision, wrong lifestyle and untimely diagnosis can lead to serious and irreversible consequences: infertility, suppuration and the development of infections.
Anatomy and physiology of seminal vesicles
Seminal vesicles are located on the side of the vas deferens. The front wall of the paired glandular organ is in contact with the bladder, and the posterior wall is in contact with the rectum (see Figure 1).
Fig. 1 - Inflammation of the seminal vesicles.
Each seminal vesicle has the shape of an accordion (a strongly convoluted tubule), its length in this form is up to 5 cm. If the vesicles are flattened, the sizes of each reach 12 cm. The lower end of the seminal vesicle is pointed. It passes into the excretory duct. The latter ends with the vas deferens in the prostatic part of the urethra at the site of the seminal tubercle. On the way to the place, the ducts pass through the thickness of the prostate gland.
Seminal vesicles perform the following functions:
- direct ejaculation process - during sexual intercourse, during ejaculation, the contents of the seminal vesicles and ducts are mixed with prostatic secretion and enter the urethra at the base of the seminal tubercle,
- “Utilization” of sperm cells - after sexual arousal has not ended with ejaculation, sperm cells return to the seminal vesicles from the ducts, where they are absorbed by spermiophages,
- fructose production - a carbohydrate is an energy source to support the mobility and vitality of male germ cells. Due to the quantitative indicator of fructose, one can judge about androgenic saturation,
- sperm protection - the seminal vesicles together with the reproductive cells produce a secret that envelops the sperm and, as it were, creates a film with a pH of 7.3. This protects the cell from the harmful effects of cervical mucus in the vagina and gives sperm resistance and resistance to the egg.
- Painful urination
- Soreness of ejaculation
- Pelvic pain
- Lower back pain
- Bowel pain
- Semen blood
- Lack of orgasm
- Premature ejaculation
- Mucus in the feces
- Frequent nocturnal erections
Vesiculitis is an inflammatory lesion that occurs in the seminal vesicles. Vesiculitis, the symptoms of which are predominantly alleviated, has no acute manifestations, which leads to late treatment of patients for the provision of appropriate medical care, and also determines some difficulties that are relevant in the process of making a diagnosis.
There are two seminal vesicles in the male body, and they are located between the prostate bladder in the front, rectum, respectively, behind. The connection of the excretory ducts of the vesicles is carried out with the vas deferens (the function of which is to ensure the transfer of sperm from the testes), which forms the deferent duct. He, in turn, opens in the prostate gland, in the prostatic part of the urethra. Note that the knowledge of the location of the area in which the seminal vesicles are located is extremely important, because it is due to this that the primary diagnosis of the disease we are considering is possible on the basis of the emerging symptoms.
As for the function that the seminal vesicles perform, it boils down to the secretion of the liquid base of the ejaculant, which subsequently mixes with the secretion from the prostate gland, as well as to spermatozoa, the secretion of which occurs in the area of the convoluted tubules of the testicles. In addition, the fluid produced in the seminal vesicles includes a significant amount of fructose, due to the presence of which the sperm is provided with the energy required for its movement. Separately, the function of sperm absorption in the situation when the sexual intercourse was incomplete is also attributed to the functions of the seminal vesicles.
Causes of Vesiculitis
Among the urgent causes contributing to the appearance of vesiculitis are, first of all, infection. Its entry into the seminal vesicle can occur under the influence of a variety of sources. In particular, these can be the urethra (which occurs with urethritis), the bladder (respectively, with cystitis), the kidneys (with pyelonephritis, glomerulonephritis), blood (due to infections of another type of organs: pneumonia, tonsillitis, osteomyelitis, skin pustules).
In addition, the following reasons are also distinguished:
- Depression of the general condition of the immune system,
- Duration of stay in a sitting position, lack of exercise,
- Excessive sexual activity or, conversely, the duration of sexual abstinence,
- Malnutrition, which results in constipation,
- Pelvic injuries
- The proximity of the seminal vesicles to the rectum, provoking fistulas between them, which, in turn, leads to vesiculitis.
Any of these reasons has the right to exist in the practice of urology, however, the most common source for infection of the considered area of the seminal vesicles is the prostate gland. The fact is that it is with her that the seminal vesicles are directly connected, which in particular is ensured by the ejaculatory flow. Accordingly, in the case of prostatitis, the infection can easily pass through a short “tube” to the vesicle, thereby causing vesiculitis. For this reason, there is a clear correlation between the prevalence of vesiculitis and prostatitis, a complication of which it becomes about 10-30% of the total number of cases.
- congestion in the organs of the scrotum and pelvis: ischemia, atherosclerosis of the feeding arteries, endarteritis of aortic bifurcation (see “Treatment and prevention of stagnation of blood in the pelvis”),
- diseases that provoke the accumulation and obstruction of the passage of the ejaculate through the natural ducts: prostate adenoma, prostate cancer, neoplasms of the bladder and rectal ampoule, fibrotic changes in the prostatic urethra,
- mixed (combination of the above reasons).
Factors that provoke blood stasis and secretion in the vesicles can often be:
- inflammatory diseases of the rectum,
- interrupted intercourse,
- incomplete ejaculation in stressful situations,
- sedentary lifestyle, sedentary mode of work,
- irregular sexual intercourse or prolonged abstinence.
Infectious non-specific causes:
Infectious specific causes:
Other rarer causes may be autoimmune processes aimed at destroying the own cells of the seminal vesicles, an allergic reaction, stress, mechanical damage to the integrity of the scrotum and, accordingly, the seminal ducts and vesicles.
The clinical picture of vesiculitis
Depending on the duration of the disease, the types of the course of the disease are distinguished:
Types of course differ in time (acute lasts up to a month, chronic - more than 3 months), symptoms and treatment methods.
Symptoms of acute and chronic vesiculitis are somewhat different, so we will consider each in detail. Sometimes it is difficult to recognize a disease, since it can have an erased clinic with weak immunity or hide behind the clinical picture of another disease.
Diagnosis of vesiculitis
Verification of vesiculitis is carried out using a special complex developed in urology in the form of diagnostic procedures. First of all, it is necessary to do a general blood test, which will determine the signs of the inflammatory process (which is manifested in an increase in the number of leukocytes, as well as in accelerating ESR).
It is noteworthy that the detection of signs indicating the relevance of the inflammatory process also indicates a general urinalysis. In it, in particular, in addition to an increase in leukocytes and red blood cells, an admixture of mucus is found, often with blood, which allows the doctor to suggest the presence of vesiculitis in the patient.
In general, the verification of the disease under consideration is carried out on the basis of data obtained by ultrasound. This examination involves examination of the prostate gland, as well as seminal vesicles. The latter in the case of the inflammatory process in them, will be increased, at the same time, the presence of a significant amount of fluid will be determined in them. Most often, the walls of seminal vesicles have an uneven density, as well as a thickening formed as a result of edema.
In order to specify the causative agent of the disease, the contents of the seminal vesicles are sown. In some cases, a spermogram is used. In this case, inflammation of the seminal vesicles will be indicated by a slowdown in liquefaction of sperm, as well as an increase / decrease in its volume, the presence of an impurity in the form of blood, and impaired sperm motility.
Reasons for the development of pathology
It is known that inflammatory processes of the seminal vesicle develop not only in older men (after 50 years), but also in representatives of young (25-30 years) and middle (30-45 years) ages. The increase in statistics is due to a deterioration in the quality of life of people.
All the reasons that provoke inflammatory disorders of the vesicles and duct can be conditionally divided into 2 main categories - this is infection and stagnation.
In turn, infectious factors are divided into typical and non-specific.
The first include: Trichomonas, gonorrhea, tuberculosis infection and mixed. To non-specific ones are viruses, bacteria, chlamydia, ureaplasma, mycoplasma, candida, gardnerella.
If we consider the bacterial microflora, then most often the causative agents of inflammation of the prostate and seminal vesicle are staphylococcal and streptococcal infections. The least common cause is Klebsiel, Pseudomonas aeruginosa or Proteus.
But congestive vesiculitis (also called congestive) are associated with congestive events in the prostate, seminal vesicles, as well as with the vas deferens, other genital glands and blood vessels in the pelvic organs and scrotum.
Which part affects vesiculitis can be seen in the picture.
There are such factors that contribute to the development of stagnant processes in this zone:
- intercourse that was interrupted
- a sign of irregularity in sex life,
- incomplete ejaculation, which is caused by stress during sexual intercourse,
- inactive lifestyle
- smoking and frequent drinking,
- sudden hypothermia,
- proctitis, hemorrhoids and other inflammatory diseases in the pelvic area.
There are several ways of infection penetrating into the seminal vesicles:
- By the circulatory system. This pathway is called hematogenous. Usually this happens with common diseases of an infectious nature. Also affects pneumonia, tonsillitis, sinusitis, cholecystitis, frontal sinusitis, cholangitis and other diseases.
- On contact (contact method). With the urinogenous ascending pathway, the infection spreads from the urethra as a result of urethritis. With a descending urinogenous pathway, the infection penetrates the ureters from the kidneys (usually this occurs with pyelonephritis). In addition, one must also take into account the ascending canalicular method, that is, the infection spreads along the vas deferens with defrentitis, funiculitis, epididymitis.
- According to the lymphatic system. In this case, a person is most often pre-treated for proctitis, paraproctitis, prostatitis, thrombophlebitis in the veins of the hemorrhoidal type.
In addition, vesiculitis in men can be the result of an allergic reaction, mechanical injury, chemical poisoning (with medicines, other chemicals), a malfunction of the immune system.
In the process of treating the disease we are considering, it is mandatory for patients to observe bed rest, which is especially important during the first days of treatment. In addition, plenty of drink and peace are prescribed. Sexual contact should be excluded.
The acute phase in combination with high temperature determines the need for the use of analgesics, as well as antibiotics, which have an extensive spectrum of effects. The elimination of problems associated with bowel movements is carried out by taking laxatives. In some situations, it is advisable to use rectal suppositories, which have a significant analgesic effect. Antipyretic and anti-inflammatory therapy is also carried out. Normalization of temperature determines the possibility of taking hot baths, as well as the use of heating pads for the crotch area.
Chronic vesiculitis, in the absence of specific contraindications, as an additional therapeutic effect, involves the appointment of physiotherapeutic procedures in the form of massage of the prostate gland and seminal vesicles, mud therapy and magnetotherapy. The chronic form of vesiculitis has been cured for a long time, which also suggests the need for systematic monitoring of the tests.
Launched vesiculitis with the formation of pus in the vesicles (which is determined in particular on the basis of the corresponding symptoms, as well as the results of ultrasound and analyzes) requires surgical intervention to cure. It consists in opening the vesicles and subsequent washing, severe cases require their removal.
In case of occurrence of symptoms characteristic of vesiculitis in any degree of severity of its manifestation, it is necessary to contact a urologist as soon as possible.
What are the symptoms?
If acute inflammation of the seminal vesicles develops, the symptoms will be as follows:
- Sudden development.
- Body temperature rises to 39ºС. A man suffers from headache, fatigue, chills, weakness. All these signs indicate a general intoxication of the body.
- Sharp pain in the pelvic area: pubis, perineum, or near the rectum. Sometimes the pain goes to the sacral region or lower back.
- When a person is pushing, the pain intensifies. The same applies to defecation, erection, ejaculation, the gradual filling of the bladder or any muscle tension in this area. Because of this, the seminal organs are compressed. If a man has right-sided vesiculitis, then painful sensations will appear only on one side.
- Mucus is released from the urethra during bowel movements. Sometimes you may notice reddish blood clots in it. Due to the fact that the seminal vesicles are located close to the intestine, during the movement of feces they are compressed, and their contents enter the urethra.
- Urination becomes more frequent. In some patients, this is due to the fact that the walls of the bladder are irritated. In addition, a man may suffer from spermatocystitis.
- Traces of blood are visible in semen. This is because the blood vessels in the seminal vesicles are damaged.
- Chubby erection. This often happens due to the fact that nerve fibers are excited. Sometimes an involuntary erection is accompanied by an ejaculation, which is called pollution.
- The volume of sperm changes, and it can both increase and decrease. This is due to the fact that a large amount of mucus is secreted, or, conversely, an outflow of matter from the organ is observed.
- The quality of sexual life is significantly deteriorating. Due to painful sensations and stress, the filling of the blood of the genitals worsens, so that the erection decreases, as does the quality of the orgasm.
Video: "Vesiculitis: symptoms and treatment"
As for the chronic form, the symptoms of vesiculitis in this case will be the same as in the acute course, but less pronounced. In addition, potency decreases, sexual disorders appear.
If the inflammation of the vesicles is chronic, then there are disruptions in the vascular and neurological mechanisms that are responsible for erection. Such a male illness can lead to infertility, since the seminal vesicles protect the sperm and are responsible for their nutrition. Due to disturbances in the functioning of organs, sperm quality is greatly deteriorated. The level of acidity of the substance, its viscosity, sperm motility changes.
To diagnose the disease, the following methods are prescribed:
- rectal examination
- examination of the contents of the seminal vesicles,
- computed tomography
- semen, blood and urine tests.
All these techniques will help determine the ailment.
Video: "What you need to know about vesiculitis?"
Medication for vesiculitis
How to treat vesiculitis, every man should know. In general, therapy is prescribed by a doctor, but the basics need to be studied.
The treatment itself is selected depending on the factors that provoked such an ailment. For example, if the patient has infectious vesiculitis, then antibiotic therapy is prescribed.
With the cognitive form of pathology, medications are used that eliminate stagnant processes in the organs of the genital and urinary systems.
If a person has an inflammatory process or signs of spermatocystitis, then symptomatic therapy is used. In any case, the treatment should be comprehensive.
Drug treatment of bacterial vesiculitis (infectious) involves the use of antibiotics.
For example, such drugs are prescribed:
- Means that belong to the macrolide group: Macropen, Sumamed, Erythromycin.
- Tetracycline antibiotics - Metacyclin, Doxycycline.
- Drugs with combined action. For example, Tetraolean or Oletetrin is suitable. Their feature is the selective effect on the tissues of the prostate, urethra and seminal vesicles. They act against mycoplasma and viruses.
- Means from the group of nitrofurans - Trifurantoin or Furagin. The active components of these medicines penetrate the secretion of the prostate and seminal vesicles.
- Preparations from the group of sulfonamides. For example, used: Trimethoprim, Bactrim.
If the patient has inflammation of the vesicles caused by rare pathogens (such as Klebsiella or Proteus) or infections of the urogenital type, then drugs from the following groups are prescribed:
- sulfonamides with trimethoprim.
In the presence of chlamydia or mycoplasmas, Dalacin and Linkomycin are prescribed, and with gardnerells, Macmirror and Miranem are prescribed. A feature of the treatment is that it is carried out simultaneously not only in men, but also in its sexual partners.
If the disease is caused by specific infections (such as gonorrhea, syphilis, tuberculosis), then Rifampicin, cephalosporins and penicillins are prescribed.
If inflammation of the seminal vesicles is caused by congestion, then such methods are used:
- Angioprotectors. For example, fit: Aescusan, Inderal, Obzidan, Venoruton, Dartilin, Agopurin, Trental.
- Massage of seminal vesicles and prostate.
- Microclysters (volume is from 10 to 100 ml, the liquid should be warm).
- UHF therapy.
- Physiotherapy with equipment such as Intraton, Yarilo, Intramag.
- Auxiliary therapy.
If the patient has vesiculitis, treatment involves the use of anti-inflammatory drugs. For example, Diclofenac or Indomethacin is suitable. They help lower body temperature, eliminate pain, inflammation, and prevent damage to nearby tissues and organs.
In addition, immunomodulators are prescribed - these are Levamisole, Pyrogenal, Tactivin, Timalin, Viferon, Soklourovak. They strengthen the protective mechanisms, as a result of which the body can fight infections.
What is vesiculitis?
Near the prostate gland there is a special paired organ - vesicles (or seminal vesicles). The main function of these vesicles is to keep the secretion that is produced by the prostate. They communicate with the vas deferens through which sperm are excreted. The inflammation of these vesicles is known as vesiculitis.
Other treatments for vesiculitis
If a man develops inflammation of the seminal vesicles, then the therapy should be comprehensive.
In addition to drug treatment, other methods are prescribed:
- Physiotherapy. Very useful is the use of UHF. Acupuncture is also used (also called reflexology). The doctor may prescribe electrotherapy. Sanitary treatment with mud rectal suppositories, mineral and mud baths, applications is necessary. Physical therapy is considered very effective. This will help strengthen both general and local immunity. The process of tissue repair is stimulated. Inflammation gradually passes, metabolism improves.
- Diet. Treatment for vesiculitis involves proper nutrition. It aims to prevent constipation. In addition, the diet will help strengthen the human immune system. Be sure to eat more fresh fruits and vegetables, fish, low-fat meat, dairy products. From the diet, it is required to exclude acidic fruits and berries, canned food, smoked meats, fatty and fried foods, coffee, strong tea, spices and products that increase the intensity of gas formation in the intestines.
- Surgical intervention. Treatment of vesiculitis in the later stages involves surgery. Usually, such a procedure is prescribed when the pathology has complications - for example, empyema. This is a condition where the seminal vesicles are full of pus. In this case, a puncture of the organ is carried out with further drainage. In the most severe cases, seminal vesicles are removed - this procedure is called vesicoelectomy.
Structure and function of seminal vesicles
We will tell you more about the structure of seminal vesicles. This paired glandular organ is located on the side of the vas deferens, above the prostate. Its front surface is in contact with the bottom of a nearby bladder. Behind the seminal vesicles are in contact with the rectal ampoule. And only the upper portion of the vesicles is covered with peritoneum. Depending on the volume of fluid in the bladder, the location of the seminal vesicles may vary.
This paired organ is spindle-shaped in shape, its thickness can reach 2 cm, its width is usually 2-4 cm, and its length is about 5-6 cm. Each seminal vesicle consists of three elements - the base, body, and excretory duct, which connects to the deferent duct . This is how the vas deferens is formed, which penetrates the entire thickness of the prostate, and then opens on the spermatic mound with a common duct (on each side).
Blood supply to the organ occurs through the descending branch of the artery of the vas deferens, and the branches of the arteries of the bladder. The outflow is carried out to the bladder venous plexus and to the internal iliac vein. Outflow of lymph - to the internal iliac lymph nodes.
Innervation - the nerve branches of the plexus of the vas deferens.
Seminal vesicles perform several critical functions. Firstly, they provide sperm with energy resources, and secondly, they protect them. And finally, the third task of the bubbles is to dispose of the remaining seminal fluid.
The secret formed in the seminal vesicles is combined with the secret of the testicles. Since it has a pH of 7.3, a protective colloid is formed, which significantly increases the resistance of sperm and improves their survival during a long advance to the egg.
If sexual intercourse is realized, seminal fluid containing sperm enters the vesicles and is utilized there. Sperm is utilized in seminal vesicles by their absorption by special cells, which are known as spermiophages.
What is vesiculitis, every man should know in time to pay attention to certain symptoms and go to the hospital. The doctor selects the treatment depending on the diagnostic results. Vesiculitis develops due to various factors, so therapy is primarily aimed at eliminating their effects. In addition, supporting methods are assigned. But it is best to know the essence of this disease and carry out prevention.
How does inflammation of the seminal vesicles occur?
In the vast majority of patients (up to 80%), the inflammatory process is due to a deterioration in the natural protective function of the cells. Immunity is reduced, first of all, under the influence of such reasons: overheating, cooling, lack of physical activity, trauma. The action of these factors makes the vesicles susceptible to pathogenic microbes, and they begin to multiply freely, causing inflammation.
Possible ways of infection and development of vesiculitis
Infection with vesiculitis can occur in the following ways:
- Hematogenous. In this case, pathogenic microbes enter the vesicles along with blood.Sources of infection can be very different: pneumonia, caries, sinusitis, sore throat. In such cases, vesiculitis is usually associated with staphylococcus, streptococcus.
- Lymphogenic. Microbes spread with lymph. Possible sources are boils, prostatitis, balanoposthitis. The pathogens of infection are Pseudomonas aeruginosa, Cocci, Proteus.
- Ascending. In this case, the infection spreads up the urinary tract mucosa. This mode of spread is characteristic of E. coli, as well as sexually transmitted infections.
What happens with inflammation of the seminal vesicles (vesiculitis)
With this disease, mucosal hypertrophy develops, and the lumen of the vesicles begins to narrow. During the acute course of the process, the outflow of contents from the vesicles is difficult, since the mucous membrane is very swollen. Due to a long inflammatory process, the epithelium begins to grow, the mucous membrane becomes thicker. There is swelling of the gland and an increase in its size.
In place of the cells responsible for the secretion, connective tissue appears. Due to its excessive proliferation, the secretory function of the vesicles suffers. The secretive epithelium begins to atrophy. In semen, the amount of organic components necessary to maintain sperm activity is reduced. Sperm itself becomes more viscous.
As a result of a deep inflammatory process, the adventitious (or outer) membrane undergoes atrophy. The main function of this cutting plate is to squeeze out the secretion of vesicles during orgasm. If she is struck and can not fully cope with her task, the gland will become much larger in volume. Moreover, stagnation can cause suppuration. A man has erectile dysfunction.
Superficial catarrhal spermatocystitis
The surface form is manifested by redness on the mucous membrane. In this case, the mucous membrane swells. And damage appears on the epithelial layer lining it. Inside the vesicle there is a purulent-mucous fluid, blood inclusions may be noted. The size of the organ is increased, and the shape is slightly stretched.
In patients with deep vesiculitis, inflammation passes to the submucosal basis, as well as muscle tissue of the vesicles. With this form of inflammation, they also increase in size, swelling and hyperemia appear. The walls are compacted, and in the lumen there is a little serous secretion with a purulent impurity.
Seminal vesicle empyema
If deep spermatocystitis has developed under the influence of pyogenic microorganisms, the seminal vesicles are filled with pus, and in rather large quantities. So there is a disease known as empyema.
By the type of course, vesiculitis can be both acute and chronic. Acute inflammation in the vesicles (as in any other organ) appears unexpectedly. The disease begins with a sharp rise in temperature, the patient is covered with weakness, pain occurs in the pelvic area. Discomfort increases during bowel movements or when the bladder is full. Most often occurs in men suffering from prostatitis, and therefore can be perceived as a complication.
Chronic vesiculitis is a more common form. He is considered a complication arising from acute inflammation. Patients complain of erectile dysfunction, impaired ejaculation, aching pain in the pelvis and perineum. In such patients, qualitative changes in the composition of sperm are noted.
Symptoms of vesiculitis in men
In many men, the inflammatory process in the seminal vesicles does not manifest pronounced specific symptoms and may be ignored. The disease often develops against the background of prostatitis, and it is difficult for the patient to distinguish the symptoms of bladder damage from the symptoms of inflammation of the prostate gland. Sudden fever (up to 39 degrees), increased pain in the perineum and more pronounced problems with urination are suggestive of vesiculitis. Discomfort in the pelvic area during intercourse. Another alarming sign is the appearance of bloody inclusions in semen. In addition, with bowel movements and a full bladder, pain will begin to intensify.
If you notice such symptoms (or at least some of them), a visit to the urologist should not be postponed. After all, inflammation of the seminal vesicles is a rather serious medical problem, which can lead to extremely unpleasant complications. Suspicious symptoms should not be ignored or attempted to be attributed to chronic prostatitis. It must be remembered that vesiculitis is a much more serious disease than chronic inflammation of the prostate.
How is vesiculitis diagnosed?
Diagnosing the inflammatory process in the seminal vesicles is not too difficult. At the first stage, after listening to the patient’s complaints, the doctor performs a rectal examination, the purpose of which is to identify pain in the front wall of the rectal ampoule. Then the patient is prescribed laboratory tests for an accurate diagnosis.
A general blood test is uninformative. He can only show that somewhere there is an inflammatory process. Laboratory tests of urine will not give more accurate results. For accurate diagnosis, it is necessary to sow the contents of the bubbles. Using a special prostate massage, the doctor selects the material for analysis in a test tube. Then the contents of the bubbles are sown in a special medium containing nutrients. Colonies of microorganisms grow over a period of time, allowing you to diagnose bacterial vesiculitis.
While waiting for the results of the tests, the patient is offered to undergo an ultrasound examination of the pelvic area. Ultrasound is performed using a special sensor through the rectum. This method makes it possible to determine the presence of an inflammatory process in the wall of the bubble. Ultrasound is referred to as indirect methods. However, its results often become a sufficient basis for the diagnosis of vesiculitis (both acute and chronic).
A standard examination method for inflammation of the seminal vesicles is vesiculography. Such a diagnosis makes it possible to exclude other diseases: tuberculosis and sarcoma. The procedure is invasive. It is performed in this way. In the area of the scrotum, an incision is made to isolate the vas deferens. Then, using a special needle, contrast is introduced into the lumen of the duct (iodolipol, verographin). Then make an x-ray.
Modern diagnostic methods include CT and nuclear magnetic resonance. They give an accurate idea of the condition of the diseased organ. But such procedures are much more expensive than traditional methods of examination. Therefore, they resort to them infrequently.
Symptoms of acute vesiculitis
- the disease begins with a sharp increase in total body temperature above 38 ° C
- chills, weakness, fatigue, headaches - intoxication syndrome,
- sharp pains in the inguinal region and perineum, which can migrate to the sacral region,
- pain is more often unilateral in nature (even in the presence of a bilateral process) due to the unequal degree of damage to the right and left seminal vesicles,
- painful sensations intensify with an overflowing bladder and an act of defecation, since at this time the contraction of the walls puts pressure on the inflamed organ. This once again provokes irritation of pain receptors,
- uncomfortable ejaculation.
Symptoms of chronic vesiculitis
The clinic of the chronic process is more associated with impaired urination and a distortion of erectile function:
- weak orgasms
- pain during sex and several hours after it,
- increased pain during ejaculation,
- renewal of pollutions,
- dysuric disorders: a change in the quality of urine and its quantity, the appearance of discomfort,
- constant aching pain in the sacrum.
How is vesiculitis treated?
If the disease was diagnosed in the early stages, the patient is shown a course of active antibacterial treatment. For this purpose, broad-spectrum agents are prescribed - macrolides, penicillins, cephalosporins and fluoroquinolones. Although all of these tools are available for sale without a prescription, self-medication is not worth it. You can take drugs only after consulting a doctor who must make an accurate diagnosis and determine the treatment regimen.
Antibiotic vesiculitis treatment regimens
With vesiculitis associated with traditional pathogens (white staphylococcus, E. coli), such treatment is indicated:
Erythromycin: 200 mg per day for 2-3 doses, the course is from a week to two.
Sumamed: the first day 500 mg in the morning and in the evening, in the next 4 days once a day, 500 mg.
Doxycycline: 100 mg twice a day for 10-12 days, on the first day once - 200 mg.
Metacycline: 300 mg twice a day (the entire course is 5-10 days).
Furagin: 50 mg 2 or 3 times a day with food, for 7-10 days.
Bactrim: 2 tablets twice a day after eating, for 5-14 days.
If vesiculitis is caused by rare pathogens (such as Klebsiella, Proteus) or urogenital infections (ureaplasma, chlamydia, gardnerella, mycoplasma), the therapy is carried out according to a different scheme.
On the first day, an immunoprotector is prescribed. And after three days, they are treated with antibiotics (macrolide or tetracycline plus biseptol), which should last 10 days. In total, it is desirable to carry out at least two ten-day courses using antibiotics of different groups.
With specific infections (syphilis, gonorrhea, tuberculosis), such therapy is indicated:
benzyl penicillin v / m 3 - 9 million units.
A treatment regimen is recommended for patients with congestive vesiculitis:
Trental: 100-400 mg, twice a day, the course lasts 2-3 weeks.
Obzidan: 1 tablet 2 or 3 times a day for three weeks.
Aescusan: 1 tablet three times a day, the duration of admission is from 10 to 20 days.
Also, with vesiculitis, UHF is often prescribed. In this case, the electrode is introduced rectally to a depth of 10 cm. One session lasts about 15 minutes, and the procedures are performed every day.
For an enema, use chamomile (or sage), novocaine. First make a cleansing enema, and then microclyster. At this time, the patient should lie in a calm position for at least 30 minutes, so that the drugs work well.
With the help of antibiotics, you can act on the microbes that caused the disease. But unfortunately they will not remove unpleasant symptoms. Therefore, the patient is usually prescribed symptomatic treatment - painkillers and antipyretics (in the form of tablets or in the form of injections). First of all, these are drugs such as Indomethacin and Diclofenac.
Significantly alleviate the patient's condition can laxative drugs. Under their influence, the patient does not experience pain during the act of defecation. But, unfortunately, their reception is inconvenient to combine with bed rest, which is recommended for men with an acute form of the disease.
The described treatment is prescribed for acute vesiculitis. With the chronic nature of the disease, some other surgical and therapeutic methods are additionally used.
So, with purulent forms of vesiculitis, an operation is necessary, the purpose of which is the drainage of the vesicles. But they can also resort to a more gentle way - washing the cavity of the vesicles through the urethra.
Prevention of vesiculitis
In order to prevent the disease from recurring, much attention needs to be paid to rehabilitation measures. One of the best ways to prevent relapse is to stay in a sanatorium where mud treatments are used. In addition, physiotherapy is very useful.
Recent medical studies have confirmed that physiotherapy in many cases can prevent the development of relapse. Researchers conducting the research argue that the likelihood of a recurring episode of the disease after physiotherapy is almost halved.
For reliable prevention, it is necessary to deal with the local causes of acute vesiculitis. As already noted, the inflammatory process in the seminal vesicles can be associated with chronic prostatitis or urethritis. Therefore, without reorganization of the primary foci simply can not do. For this, preventive antibacterial courses and local antiseptic treatment are prescribed.
To prevent the re-development of the disease, you must be careful about personal hygiene. It is often necessary to change underwear and regularly perform a toilet of the genitals. This rule is relevant for the prevention of any urogenital disease.
Sometimes the source of inflammation becomes a focus of infection, located at a great distance from the vesicles. Therefore, no focus of purulent inflammation in the body can be ignored. This applies even to decayed teeth.
In addition, we must not forget that the complete absence of foci of infection is not a guarantee that there is no risk of vesiculitis. In medical practice, there are cases when the disease occurred in completely healthy men as a result of severe hypothermia.
The consequences of vesiculitis in men
A serious consequence of vesiculitis is suppuration in the vesicles. The development of such a complication is indicated by severe pain in the sacral and inguinal areas, fever, feeling of chills, severe weakness. Such a patient should be urgently placed in a hospital for surgical treatment. Surgery cannot be dispensed with, since there is a high risk of involving other organs in the infectious process. As a result, fatal sepsis may develop.
Another serious complication of vesiculitis is infertility. Vesiculitis can cause the seminal vesicles to dry out and they will no longer be able to fulfill their function. Also, problems with an erection arise, the quality of an orgasm worsens.
Other symptoms that accompany each type of vesiculitis and do not depend on the type of course:
- azoospermia - a decrease in the normal sperm content in the ejaculate, which is the main cause of male infertility,
- pyospermia - the presence of pus in the seminal fluid,
- pyuria - excretion of urine with the presence of pyogenic masses,
- noticeable drops of blood in semen.
Diagnosis of the disease
After a thorough examination and examination, the attending physician identifies the leading symptoms and outlines a preliminary diagnosis and further instrumental and laboratory research methods.
Laboratory tests are immediately taken:
- General blood analysis,
- General urine analysis,
- Semen analysis,
- Investigation of seminal fluid.
A general blood test will show the presence of an inflammatory reaction in the body. This is evidenced by an increased erythrocyte sedimentation rate (more than 15), a shift in the leukocyte formula to the left (towards young leukocytes) and an increased amount of the total number of leukocytes.
A general urinalysis will reveal the presence of red blood cells, bacteria and white blood cells in the test fluid. Sometimes there is the presence of urate.
In the case of an inflammatory process, a spermogram will show:
- the presence of white blood cells and red blood cells in the ejaculate,
- sperm count reduction,
- change in the ratio of motile spermatozoa to motionless,
- the presence of pathogens,
- quantitative lack of fructose in seminal fluid.
For the study of seminal fluid, catheterization of the bladder is carried out with its further filling with an isotonic solution. After the flood, the seminal vesicles are massaged and at the end of the procedure they ask the patient to urinate. In the test urine, the same indicators are found as in the general analysis of urine, only in large quantities and directly from the testes.
Of instrumental research methods use vesiculography, ultrasound diagnostics, computed tomography and magnetic resonance imaging.
All these research methods will show an increase in seminal vesicles in size, thickening of the wall, and a change in the shape of the outer and inner surfaces. The difference lies in the clarity and detail of the changes described.
Complications of vesiculitis and its prevention
In the absence of treatment and improperly selected therapy, prolonged inflammation, there may be the following complications:
- empyema of seminal vesicles - it is dangerous to capture other organs in the process,
- irreversible infertility
- decreased orgasm quality
- violation of erectile function.
To avoid such complications and the disease itself, you need to follow some rules:
- protected sex and regular sex life,
- active lifestyle, outdoor activities and sports,
- avoid excessive drinking, smoking,
- don't get too cold
- avoid stress
- timely diagnosis and treatment of chronic infectious foci and diseases of the genitourinary system.
Watch a video on the causes, symptoms and diagnosis of vesiculitis