Where are the seminal vesicles located and why do they become inflamed?
The seminal vesicles are located behind the bladder, above the prostate, and their ducts join the vas deferens to form the ejaculatory ducts. This is why the infection easily spreads between the prostate and the vesicles. Most often, the causative agents are E. coli and other opportunistic bacteria, as well as chlamydia, gonococci, and Trichomonas in sexually transmitted infections. Inflammation is promoted by stagnation of secretions during prolonged abstinence or, conversely, with excessive activity, sedentary work, hypothermia and constipation, which impair blood circulation in the pelvis.
- Spread of infection from the prostate
- Ascending infection from the urethra
- Sexually transmitted infections
- Introducing bacteria through the bloodstream during general infections
- Stagnation of secretions and poor circulation in the pelvis
- Hypothermia and chronic constipation
Symptoms of acute and chronic form
Acute vesiculitis begins with fever, weakness and pain in the depths of the pelvis, perineum, above the pubis or in the sacrum. The pain often radiates to the rectum and intensifies with bowel movements and a full bladder. A very characteristic sign is pain at the time of ejaculation and an admixture of blood in the semen, due to which it acquires a rusty or brownish tint. The chronic form is milder: there remains aching discomfort in the perineum, periodic hemospermia, frequent urination, decreased quality of orgasm and sometimes problems with conception.
- Pain in the perineum, above the pubis and in the sacrum
- Increased pain during ejaculation
- Blood in semen, brownish tint of ejaculate
- Increased temperature in acute form
- Frequent and painful urination
- Decrease in ejaculate volume in chronic course
Diagnostics
The urologist begins with an examination and digital rectal examination: with vesiculitis, the vesicles are enlarged and painful. The main instrumental method is TRUS, which shows the expansion and thickening of the walls of the seminal vesicles, the presence of thick contents or pus in them. Be sure to examine urine and prostate secretions with a culture, take a smear from the urethra and do PCR for sexually transmitted infections. A spermogram helps assess the impact on fertility and often reveals an increase in white blood cells. For repeated hemospermia in men over 40 years of age, other causes are excluded.
- Digital rectal examination
- TRUS of the prostate and seminal vesicles
- General analysis and urine culture
- Prostate secretion culture
- PCR for sexually transmitted infections
- Spermogram
Treatment
The basis of treatment is an antibiotic, selected based on culture results and capable of penetrating the glandular tissue. The course is long, usually several weeks: short therapy almost always leads to a return of symptoms. Additionally, anti-inflammatory and painkillers and drugs that improve the outflow of secretions are prescribed. After acute inflammation subsides, physiotherapy and therapeutic massage are used, but only as prescribed by a doctor: in acute cases they are contraindicated. With purulent vesiculitis and abscess formation, ultrasound-guided drainage is required.
- Antibiotic based on culture results, long-term course
- Anti-inflammatory and painkillers
- Physiotherapy after acute inflammation subsides
- Massage of seminal vesicles only as prescribed by a doctor
- Drainage during purulent process
- Examination and treatment of the partner for sexually transmitted infections
Recovery and prevention
After treatment, tests are monitored and TRUS is repeated, and it makes sense to retake the spermogram after two to three months, since sperm maturation takes about 70 days. At this time, it is useful to establish regular sex life without prolonged abstinence, give up alcohol and spicy foods, and avoid hypothermia and prolonged sitting. Timely treatment of prostatitis and sexually transmitted infections is the main preventive measure. You should not resort to heating and traditional methods: with active inflammation, they worsen the situation.
- Control tests and TRUS after treatment
- Repeat spermogram after 2–3 months
- Regular sex life without long-term abstinence
- Breaks during sedentary work, moderate activity
- Avoiding hypothermia
- Treatment of prostatitis and sexually transmitted infections
