Diagnostic and Therapeutic Approaches for Seminal Vesicle Disorders

Seminal vesicle disorders encompass a range of rare but clinically significant conditions, including infection, cystic change, calculi formation, haematospermia and both benign and malignant neoplasms. Early and accurate diagnosis is critical to preserve fertility, alleviate pain and prevent progression to obstructive complications. Contemporary diagnostic pathways integrate patient history and symptomatology—most notably haematospermia and lower urinary tract symptoms—with high-resolution imaging modalities such as transrectal ultrasonography and endorectal magnetic resonance imaging (MRI). Endoscopic evaluation via transurethral seminal vesiculoscopy permits direct visualisation, targeted sampling and minimally invasive intervention, while advanced surgical approaches address large cysts, obstructive lesions and tumours. Pharmacological management of inflammatory disorders and antimicrobial prophylaxis play supportive roles. Emerging technologies, including refined endoscopic instruments and novel imaging sequences, are enhancing diagnostic sensitivity and therapeutic precision, with a global shift towards organ-preserving strategies and personalised treatment algorithms.

Research from Nature Portfolio

Recent studies have demonstrated the safety and efficacy of transurethral seminal vesiculoscopy in patients with refractory haematospermia and ejaculatory duct obstruction. Detailed analyses of pelvic MRI signals have classified seminal vesicle pathology into signal-intensity abnormalities, cystic lesions, vesicle dilatation and stone formation. Endoscopic interventions tailored to each category—ranging from fenestration of the prostatic utricle to transurethral resection or incision of the ejaculatory duct—have yielded high rates of symptom resolution, with follow-up extending up to six years and minimal complications. These findings underscore the role of image-guided endoscopy as a first-line therapeutic tool and illuminate prognostic factors based on lesion subtype and anatomic variation.

Diagnostic and Therapeutic Approaches for Seminal Vesicle Disorders publication trend

The graph below shows the total number of articles in diagnostic and therapeutic approaches for seminal vesicle disorders across all publications each year (not limited to Nature Index journals).

Technical terms

Haematospermia: presence of blood in ejaculate, often signalling seminal vesicle pathology.

Seminal vesiculoscopy: endoscopic procedure for direct visualisation and treatment of seminal vesicle disorders via the urethra.

Ejaculatory duct obstruction: blockage of ducts conveying semen from vesicles and vas deferens to the urethra, leading to backpressure and symptoms.

Endorectal MRI: magnetic resonance imaging performed with an endorectal coil to achieve high-resolution views of pelvic structures.

Transrectal ultrasonography: ultrasound imaging using a rectal probe to evaluate the seminal vesicles, prostate and adjacent tissues.

References

1. Detecting diseases of neglected seminal vesicles using imaging modalities: A review of current literature. International Journal of Reproductive BioMedicine (IJRM) (2016).
2. Etiology of 305 cases of refractory hematospermia and therapeutic options by emerging endoscopic technology. Scientific Reports (2019).
3. Transurethral seminal vesiculoscopy for intractable hematospermia: experience from 144 patients. BMC Urology (2021).
4. Endorectal magnetic resonance imaging in persistent hemospermia. International braz j urol (2008).