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Immunohistochemical characteristics of estrogen receptor alpha positive cells in glandular epithelium of the rat seminal vesicle.

Epithelial cells of the rat seminal vesicle stained positively for nuclear estrogen receptor alpha (ER alpha). We studied these cells using immunohistochemical means. We demonstrated in a previous study that some glandular epithelial cells of the seminal vesicles of immature castrated rats treated with estrogen for 1-2 weeks had multilayer features. The present study shows that these glandular epithelial cells are nuclear ER and basal cell-specific cytokeratin (34betaE12) positive. These findings suggested characteristics of basal cells. Moreover, we demonstrated that these cells express transforming growth factor beta1 (TGFbeta1) as a result of castration and estrogen treatment. Our findings indicate that glandular epithelial cells with multilayer features, which stained positively for nuclear ER alpha have basal cell features and may play an important role in the expression of TGFbeta1 through an epithelial-stromal interaction.

Animals↗

Development of peptide-containing nerves in the human fetal vas deferens and seminal vesicle.

OBJECTIVE: To use immunohistochemical methods to study the developing autonomic innervation of the human fetal vas deferens and seminal vesicle. MATERIAL AND METHODS: Thirteen pre-natal specimens ranging in gestational age from 13 to 30 weeks were acquired following abortion or miscarriage. The overall innervation of each specimen was visualized using protein gene product 9.5 (PGP), a general nerve marker, while the onset and development of specific neuropeptide-containing sub-populations were investigated using antisera to neuropeptide Y (NPY), vasoactive intestinal peptide (VIP), substance P (SP), calcitonin gene related peptide (CGRP), bombesin (BOM), somatostatin (SOM), and met-enkephalin (ENK). In addition the occurrence and distribution of presumptive noradrenergic nerves was studied using antisera to dopamine-beta-hydroxylase (D beta H) and tyrosine hydroxylase (TH). RESULTS: At 13 weeks numerous PGP, D beta H, TH, NPY and ENK immunoreactive (-IR) nerve trunks were present in the adventitia of the vas deferens and seminal vesicle but at this stage nerve fibres were not present in the smooth muscle coat of either organ. By 17 weeks, fine PGP-, D beta H, and TH-IR nerve fibres had penetrated the outer aspect of the muscle coat of the seminal vesicle but not the vas deferens. At 20 weeks a branching network of PGP-, D beta H- and TH-IR nerve fibres occurred throughout the full thickness of the muscle coat of the seminal vesicle while similar nerves were present only in the outer half of the muscle coat of the vas deferens. At 23 weeks the full thickness of the muscle coat of the vas deferens was richly innervated by a branching plexus of PGP-IR nerves. Many of these adventitial and intramuscular nerves were immunoreactive for D beta H or TH while some were immunoreactive for either NPY or ENK. Occasional adventitial nerves were immunoreactive for SP or CGRP, these being first observed at 20 weeks. VIP-IR nerves were extremely rare in the muscle coat of either organ, being first observed at 17 weeks in the seminal vesicle and at 20 weeks in the vas deferens where they mainly formed perivascular plexuses. PGP-IR nerves were first observed in the submucosa of the seminal vesicle at 20 weeks and in the vas deferens at 21 weeks. Some of these nerves were perivascular in location while other formed a subepithelial plexus which increased in density with increasing gestational age. At 22 weeks of gestation some of the submucosal nerves were immunoreactive for SP or NPY, while at 30 weeks NPY-IR nerves formed the majority of subepithelial nerves. Occasional VIP-IR subepithelial nerves were first observed at 26 weeks but were extremely rare even at 30 weeks. Submucosal nerves immunoreactive for CGRP, D beta H, TH or ENK did not occur in any of the specimens examined. CONCLUSION: (i) From 13 weeks gestation autonomic nerves develop in the muscle coat of the fetal seminal vesicle and vas deferens, being denser in the seminal vesicle than the vas deferens up to 23 weeks gestation. (ii) The majority of the intramuscular nerves in either organ contain D beta H, TH, NPY and ENK and are presumably noradrenergic in type. (iii) A subepithelial nerve plexus develops around 20 weeks gestation and contains NPY but not VIP, unlike the adult organs. (iv) Scattered neuroendocrine cells immunoreactive for SOM are present in the mucosa of the seminal vesicle from 23 weeks of gestation.

Autonomic Nervous System↗

The development and differentiation of human seminal vesicles.

The development and differentiation of the human seminal vesicles has been studied using 14 human male fetuses and 4 postnatal specimens. Earlier accounts of the morphogenesis of the seminal vesicle have been reviewed and commented upon in the light of the present findings. Previously undocumented observations include the movements of the mesenchyme, the formation of epithelial folds and the development of the lamina propria and tunica muscularis. Epithelial differentiation is also described. The function of the basal cells and the possible prepubertal secretory activity of the seminal vesicle are discussed. More work is required on the differentiation of the vesicle between birth and puberty.

Adolescent↗

Adenomyosis of the seminal vesicle with hematospermia.

A 62-year-old man presented in 1987 with hematospermia. No abnormal findings were observed by cystourethroscopy. Ultrasound showed the enlargement of the right seminal vesicle. The right seminal vesicle could not be visualized by seminal vesiculography. Computed tomographic scan revealed a homogeneous mass at the right dorsolateral aspect of the prostate. Surgical exploration was performed. The prostate and bilateral seminal vesicle were resected. Pathological diagnosis was adenomyosis of the right seminal vesicle.

Blood↗

Fine structural studies of rat seminal vesicle in castrated and intact animals following estrogen treatment.

The effect of estradiol and/or testosterone upon secretion by seminal vesicle in castrated and intact rats was assessed in young adult Sprague-Dawley rats, using light microscopy (LM), transmission (TEM) and scanning (SEM)electron microscopy. Hormones were injected daily for ten days beginning ten days after castrations were performed. The normal rat seminal vesicle, as revealed by SEM, was characterized by a large saccular lumen with highly folded walls. Cell surfaces were covered with microvilli, or occasionally displayed a protruding, ruffled surface, sparsely covered with short microvilli. Cytology was normal in testosterone-treated animals. Estradiol treatment of castrated animals stimulated secretion by seminal vesicle epithelial cells as evidenced by the presence of normal secretory bodies, the presence of RER, and moderately hypertrophied Golgi complexes. These glands were not heavier than were glands from castrated, untreated animals, although the epithelial cells were significantly taller. Secretion was maintained in intact animals treated with estradiol, although glands were smaller and epithelial height was reduced. Estradiol and testosterone treatment in combination did not appear to have an additive effect on secretion, weight of the gland, or epithelial height. The following results support the hypothesis that estrogen-induced prolactin synthesis and release may be involved in the mechanism by which estradiol effected stimulation of seminal vesicle epithelium. Prolactin-treated, castrated animals exhibited focal areas of stimulated epithelium. In hypophysectomized animals (untreated controls), the seminal vesicle epithelium retained some secretory bodies and secretory fluid in the glandular lumen; epithelial height was taller than that in castrated controls. Estrogen treatment reduced the epithelial height to that of castrated controls; there was no evidence of secretion. This suggests that in the absence of anterior pituitary hormones, including prolactin, the stimulatory effect of estradiol on seminal vesicle epithelium was nullified. In adrenalectomized/castrated animals, estradiol treatment stimulated secretion in seminal vesicle epithelium just as in non-adrenalectomized/castrated animals. This indicates that the adrenal gland plays a non-essential role in the action of estrogen on seminal vesicle epithelium.

Adrenal Cortex Hormones↗

Transrectal ultrasound-guided transperineal and transrectal management of seminal vesicle abscesses.

OBJECTIVE: The treatment of seminal vesicle abscesses (SVA) by transrectal ultrasound-guided transrectal and transperineal approaches were evaluated in this study. MATERIALS AND METHODS: Six SVA cases were diagnosed among 2350 patients admitted to our ultrasound unit with prostate and seminal vesicle symptoms during the last 6 years. Four out of six cases had bilateral, and two had unilateral SVA. Transperineal puncture and aspiration was done in four patients with bilateral abscesses and transrectal approach was preferred in two patients with unilateral abscesses. RESULTS: For both approaches, the aspiration was successfully done without any complication. The mean durations of intervention were 64 and 13 min, and the durations of hospitalization were 2 and 3 days for the transperineal and transrectal approaches, respectively. CONCLUSION: Transrectal ultrasound examination allows simultaneous evaluation of the gland and the guidance for a needle puncture and aspiration. Furthermore, rapid pain relief, regression of other symptoms, minimally invasive technique and shorter hospitalization seem to be important features as compared with conservative and surgical treatment modalities.

Abscess↗

A dose-volume histogram analysis of the seminal vesicles in men treated with conformal radiotherapy to 'prostate alone'.

BACKGROUND AND PURPOSE: There is no consensus on whether the seminal vesicles should be included in the clinical target volume (CTV) for radiotherapy of localized prostate cancer. To inform the debate, we have undertaken a dose-volume histogram (DVH) analysis of the seminal vesicles in patients treated with escalated dose conformal radiation to 'prostate alone'. MATERIAL AND METHODS: Twenty-five consecutive patients receiving conformal radiation to the prostate, to a dose of 75.6 Gy in 42 daily fractions, were studied. The CTV was defined as the prostate only, and the planning target volume (PTV) was defined by a 10 mm margin, except posteriorly where the margin was 7 mm. DVHs were calculated for the entire seminal vesicles, and for 6 mm segments through the seminal vesicles. RESULTS: Incorporating a correction for organ motion, the D90 (minimum dose received by 90% of the volume of interest) for the most inferior 6 mm volume of the seminal vesicles (SV1) ranged from 25 to 70 Gy, and the percentage volume of SV1 receiving 50 Gy ranged from 47-100%. Using a D90 of 50 Gy as a cut-off, eight of the 25 patients had unacceptably low-dose coverage of SV1. CONCLUSIONS: Escalated dose conformal radiation to the 'prostate alone' does not ensure adequate dose coverage of even the most inferior 6 mm of the seminal vesicles. We consider such treatment acceptable in patients at low risk of seminal vesicle involvement (T1/2ab, Gleason < or = 7, PSA < 10 ng/ml). In higher risk patients, if it is deemed necessary to treat the possibility of sub-clinical seminal vesicle involvement, this should be reflected in the definition of the CTV.

Dose-Response Relationship, Radiation↗

Seminal vesicle cysts: association with adult polycystic kidney disease.

Adult polycystic kidney disease (APKD) is associated with cyst formation in the kidney, liver, pancreas, esophagus, ovary, uterus, and brain. Four patients with APKD (aged 45-65 years) with computed tomographic evidence of seminal vesicle cysts are described. All seminal vesicles contained cystic masses with attenuation values of 0-30 HU. Seminal vesicle thickness was 3-4 cm (normal, 1.5 cm). High-attenuation walls separated the cysts, which were 3-35 mm in diameter. All patients had typical renal stigmata of APKD. None had cysts elsewhere, except one patient with hepatic cysts. Postmortem examination in one patient confirmed the seminal vesicle cysts as well as APKD. It is likely that a basement membrane defect allows cyst formation in multiple organs, presumably including the seminal vesicles. Because of the association of seminal vesicle cysts with ipsilateral urogenital anomalies, and because only 60% of patients with APKD have a relevant familial history, the kidneys of patients with cross-sectional imaging evidence of seminal vesicle cysts should also be studied.

Cysts↗

Androgens affect the processing of secretory protein precursors in the guinea pig seminal vesicle. I. Evidence for androgen-regulated proteolytic processing.

The guinea pig seminal vesicle epithelium synthesizes and secretes four major secretory proteins (SVP-1-4). Previous work has established that these four proteins are cleaved from two primary translation products in a complex series of protein processing reactions. The present studies suggest that these protein processing reactions are regulated by androgens. In vitro labeling of seminal vesicle proteins revealed significant differences in the patterns of secretory protein intermediates produced by tissue from intact and castrated animals. Seminal vesicle tissue explants from castrated animals secreted a subset of the processing intermediates secreted by tissue from intact animals. The changes in the patterns of secretory protein intermediates became more pronounced with increasing time after castration, and were fully reversible by treatment of castrated animals with testosterone, suggesting that androgens were affecting the processing or secretion of secretory protein precursors. Amino-terminal protein sequencing of secretory protein processing intermediates that accumulate in the seminal vesicle lumen after castration suggests that the guinea pig seminal vesicle contains an androgen-regulated proteolytic processing activity.

Animals↗

Seminal vesicle aspiration in spinal cord injured men: insight into poor sperm quality.

PURPOSE: In men with spinal cord injury poor quality semen is seen when performing electroejaculation and penile vibratory stimulation. We determined whether sperm stasis within the seminal vesicles is a potential cause of this problem. MATERIALS AND METHODS: Seminal vesicle aspiration was performed immediately before electroejaculation or penile vibratory stimulation in men with aspermia secondary to spinal cord injury. Sperm count and quality of seminal vesicle aspiration and subsequent ejaculation were compared with historical ejaculated counts, ultrasound findings and patient characteristics. RESULTS: Mean total number of right plus left seminal vesicle sperm plus or minus standard deviation was 511 +/- 960 x 10(6). Mean total number of sperm obtained by seminal vesicle plus electroejaculation or penile vibratory stimulation was 918 +/- 1,261 x 10(6). Average motility and viability of the seminal vesicle aspirated sperm were 1.3 and 3.2%, respectively. Average motility of the ejaculated sperm was 26.4% after seminal vesicle aspiration versus 16.3% in previous ejaculation induction procedures performed in the same patients. Seminal vesicle aspirated sperm represented 66% of the total number of sperm obtained during the session and was equal to 49% of the sperm obtained at previous electroejaculation or penile vibratory stimulation sessions. The period of abstinence correlated only with ejaculate count (simple regression p = 0.009). No other clinical characteristics had any effect on sperm count or quality. CONCLUSIONS: Large numbers of poor quality sperm are present within the seminal vesicles of spinal cord injured men and these sperm comprise a large portion of the specimens collected by electroejaculation or penile vibratory stimulation. This phenomenon is independent of the period of abstinence, implicating disordered storage of sperm due to spinal cord injury rather than infrequent ejaculation. The large number of senescent sperm within the seminal vesicles appears to be a primary cause of poor sperm quality in spinal cord injured men.

Adult↗

Control of reabsorption of water and electrolytes by guinea-pig seminal vesicle in vivo.

Guinea-pig seminal vesicles reabsorbed Na+ and K+ in vivo from a standard bicarbonate buffer against both electrical and chemical gradients. Water was reabsorbed with the ions. Concentrations of Na+ and K+ in the reabsorbate were greater than in plasma or the initial buffer perfusate. Guinea-pigs castrated for 6 days did not reabsorb water or electrolytes, but daily administration of testosterone or 5 alpha-dihydrotestosterone restored normal reabsorption rates. Addition of prostaglandin E-2 to the perfusate inhibited water and Na+ reabsorption. Section of the hypogastric nerve did not affect reabsorption rates measured 10 days later. We suggest that the guinea-pig seminal vesicle maintains a basal reabsorptive capacity to remove electrolytes and water that diffuse or are secreted into the lumen and that the reabsorptive pump may be coupled to a secretory one activated intermittently and perhaps partly modulated by prostaglandins.

Absorption↗

[Probability of seminal vesicle involvement in localized prostatic carcinoma. Significance in conformal radiotherapy].

PURPOSE: The development of objective criteria for selecting patients for seminal vesicle irradiation on radical radiotherapy for prostate cancer will be important for successful planning of 3D conformal radiotherapy. MATERIALS AND METHODS: Based on morphometric studies from radical prostatectomy specimens, new imaging modalities with potential in the investigation of patients with gross seminal vesicle involvement and clinical factors with potential in the identification of patients with subclinical disease the development of objective guidelines is possible. RESULTS: Clinical tumor stage as determined by digital rectal examination, diagnostic tumor biopsy (Gleason Score), and pretherapy serum prostate-specific antigen value were significant factors for the probability of involvement of seminal vesicles. Studies show that seminal vesicle involvement is unlikely if the PSA is < 4 ng/ml or 4 to 10 ng/ml and Gleason Score < 7 and stage < or = T2b. In contrast, involvement of seminal vesicles is highly likely with levels above 20 ng/ml. In patients with PSA levels between 10 and 20 ng/ml and Gleason Score < 7 ultrasonographic findings with regard to tumor volume and localization will be useful to determine the extent of the target volume. For treatment planning a significant reduction in the volumes of irradiation to the rectum and bladder is evident when seminal vesicles were excluded. CONCLUSION: Prospective use of the objective criteria will be useful in the selection of patients for seminal vesicle involvement and should be an integral part in 3D conformal radiotherapy of prostate cancer.

Biopsy↗

Relationships between seminal vesicle size and copulatory activity in bulls.

Two experiments were designed to investigate the hypothesis that dimensions of the seminal vesicle are positively correlated with copulatory behavior in bulls. In Experiment 1, thirty Santa Gertrudis bulls (16.5 mo old) were used to study the relationship between copulatory activity and seminal vesicle length and width (palpation per rectum), seminal vesicle thickness (ultrasonography), and volume. The bulls showed a low level of copulatory activity (6.0+/-1.5, 0.8+/-0.3 and 0.3+/-0.1 for mean number of mounts, intromissions and ejaculations, respectively) in 2 tests. The mean number of mounts but not the mean number of intromissions or ejaculations differed (P<0.01) among bulls. No significant correlations were found between seminal vesicle size and any of the variables of sexual behavior. In Experiment 2, 16 beef bulls (18 mo old) were used to study the relationship between copulatory activity and seminal vesicle length (palpation) or dorso-ventral thickness (ultrasonography). Differences were detected (P<0.01) among bulls in mean number of mounts, intromissions and ejaculations achieved in 2 serving capacity tests. No significant correlations were found between copulatory activity and seminal vesicle length or thickness. These data do not support the hypothesis of a positive relationship between seminal vesicle length or thickness with copulatory activity, even for bulls with marked diffences in intensity of sexual behavior.

Journal Article↗

Electron microscopic immunolocalization of caltrin proteins in guinea pig seminal vesicles.

Caltrins, the small, basic proteins of the seminal vesicle secretion that inhibit calcium transport into epididymal spermatozoa, and consequently the onset of the acrosome reaction and the hyperactivated motility, were localized in the epithelial cells and the lumen of the seminal vesicles of the guinea pig by an immunocytochemical procedure and electron microscopy. Rabbit antisera against each protein (caltrin I or II), and goat anti-rabbit IgG antiserum labeled with colloidal gold were used to detect the caltrin immunoreaction. The subcellular distribution of the gold labeling was occasionally localized in the rough endoplasmic reticulum but mainly within big secretory vacuoles containing low electron-dense material, which are components of the Golgi complex known as condensing vacuoles. These are involved in the intracellular transport, storage, and discharge of secretory proteins. Gold-labeled material released to the lumen was also detected. There was no clear evidence that the discharge was mediated by an exocytotic process. Immunoreaction was observed neither in the electron-dense core nor in the electron-lucent halo of the typical secretory granules of the epithelial cells of the seminal vesicles. Using light microscope immunocytochemistry, intense positive immunoreactivity was detected in the material secreted to the lumen but not on the epithelial cell layer. Only those cells undergoing a degenerative process and showing a picnotic nucleus and condensed cytoplasmic matrix exhibited detectable immunoreaction when gold label and silver intensification were applied. The same distribution of the immunoprobes was obtained by electron or light microscopy when antiserum to either I or II was used. It would appear that the two caltrin proteins of the guinea pig are synthesized in the rough endoplasmic reticulum of the epithelial cells and transported quickly to the Golgi complex where the secretory vacuoles (condensing vacuoles) are formed. The proteins are transported by the secretory vacuoles to the apical ends of the cells to be discharged into the lumen.

Animals↗

Ultrasound-guided seminal vesicle biopsies in prostate cancer.

Invasion of prostatic adenocarcinoma into the seminal vesicles (SV) is generally accepted as an index of poor prognosis. The pre-operative identification of SV invasion is an important element in staging since it may alter subsequent treatment decisions. We studied the possibility of diagnosing SV invasion with two biopsies from the junction between the prostate and seminal vesicles. Also we studied the correlation of several prognostic factors with the risk of clinical stage T(1,2,3) prostate cancer patients of having cancer growth into the seminal vesicles. Consecutive patients referred for transrectal ultrasound (TRUS) and biopsy because of clinical suspicion of prostate cancer were examined. This staging procedure was evaluated in patients who underwent a pelvic lymphadenectomy and radical retropubic prostatectomy (RRP). In 83 out of 138 patients prostate cancer was detected whereas 55 patients had benign disease. In 44% of prostate cancer patients a positive SV biopsy was found. The accuracy of the biopsies adjacent to the junction of the SV and the prostate was 91%. The best predictors for SV invasion were tumor grade of the biopsy sample (P<0.001), serum prostate-specific antigen (PSA) (P<0.0005), PSA density (P<0.0005) and clinical stage (P<0.0005). No significance was found in the relation to seminal vesicle involvement with free/total (f/t) PSA ratio (P=0.588) for the prostate cancer group (SV+ and SV-). In a receiver operating characteristic curves analysis, PSA density was significantly more accurate for prediction of SV invasion than PSA or f/t PSA ratio. In five prostatectomized patients (and negative SV biopsy) no SV invasion was found in the final pathologic examination either. SV biopsy at the junction of the SV and prostate is accurate for staging with high efficacy and low morbidity. To predict SV invasion in prostate cancer patients, PSA density was more accurate than PSA or f/t PSA ratio. The determination of the f/t PSA ratio in patients with low and intermediate PSA levels (eg <15 &mgr;g/L) is not useful to estimation of the risk of seminal vesicle involvement. The combination of serum PSA concentration, PSA density, tumor grade from the biopsy specimens ad clinical stage provides the best prediction of SV invasion. These parameters are identical to the conventional predictors of pathology after RRP. SV biopsies may provide additional information; if one or both basal biopsies are positive, a clinical T(1,2) disease is altered to T(3). Hence SV biopsy is useful for selection of patients who might obtain good results from RRP for prostate cancer. Prostate Cancer and Prostatic Diseases (2000) 3, 100-106

Journal Article↗

Senile seminal vesicle amyloid is derived from semenogelin I.

Senile seminal vesicle amyloid (SSVA), one of the most common forms of localized amyloidosis, is associated with the male aging process. Although it had been posited that the amyloidogenic component originated from exocrine cells and that, on the basis of immunohistochemistry, that the amyloid was composed of lactoferrin, the nature of SSVA was never established definitively. To address this issue, we have used our microanalytic techniques to characterize the structure of the congophilic green birefringent protein extracted from 5 such amyloid-containing specimens. Mass spectrometric analysis revealed that in all cases, the fibrils were composed mainly of polypeptide fragments identical in sequence to the N-terminal portion of the major secretory product of seminal vesicles, namely semenogelin I (SgI). Although lactoferrin was detected in 3 instances, the trace amount and seemingly intact form of this molecule indicated that it was not the amyloidogenic molecule. The SgI nature of the amyloid was confirmed through demonstration that the deposits were immunostained specifically with Sgl-reactive antibodies. The results of our research provide unequivocal evidence that SSVA is derived from SgI, and we provisionally designate this form of amyloidosis as ASgI.

Aged↗

Indications for seminal vesicle biopsy and laparoscopic pelvic lymph node dissection in men with localized carcinoma of the prostate.

PURPOSE: The ability of seminal vesicle biopsy and laparoscopic pelvic lymph node dissection to identify patients with stage T3 or N+ disease before undergoing treatment for localized carcinoma of the prostate was investigated. MATERIALS AND METHODS: A total of 157 patients with clinical stages T1a to T2c prostate cancer underwent ultrasound guided seminal vesicle biopsy (3 on each side) and 130 underwent subsequent laparoscopic pelvic lymph node dissection. RESULTS: Of 157 patients 23 (14.6%) had a positive seminal vesicle biopsy. Predictors of a positive seminal vesicle biopsy were stages T2b to T2c versus T1a to T2a disease (20% versus 4%, respectively, p = 0.005), Gleason score 7 or more versus less than 7 (34% versus 9%, respectively, p < 0.0001) and prostate specific antigen (PSA) 4 to 10 ng./ml., 10 to 20 ng./ml. or more than 20 ng./ml. (9%, 14% and 27%, respectively, p = 0.03). Of 130 patients 14 (10.7%) had a positive laparoscopic pelvic lymph node dissection. Predictors for a positive laparoscopic pelvic lymph node dissection were Gleason score 7 or more versus less than 7 (32% versus 2%, respectively, p < 0.0001), PSA more than 20 ng./ml. or less than 20 ng./ml. (24% versus 4.5%, respectively, p = 0.009) and stage T2b or T2c (15% and 24%, respectively, p = 0.056). Of the patients with a positive seminal vesicle biopsy 48% had a positive laparoscopic pelvic lymph node dissection (p < 0.0001). CONCLUSIONS: All patients with a Gleason score more than 4, PSA more than 10 ng./ml. or clinical stage T2b or more should undergo seminal vesicle biopsy, and those with a positive seminal vesicle biopsy or Gleason score 7 or greater should undergo laparoscopic pelvic lymph node dissection before initiating therapy for localized carcinoma of the prostate.

Aged↗

Study of the seminal vesicles in acute epididymitis.

Although it has been suggested that seminal vesiculitis is present in patients with epididymitis, it has not been proven. We performed rectal ultrasound assessment of the seminal vesicles in 18 consecutive patients with epididymitis. The seminal vesicles on the same side as the epididymitis was significantly enlarged in 75% of cases; 92% of these enlarged vesicles returned to normal size in 12 weeks. A persistently enlarged seminal vesicle was associated with unresolved epididymitis, and further bacteriological studies in these cases demonstrated continued Chlamydia infection in some patients over 35 years of age.

Acute Disease↗