Seminal vesical abscesses are a complication of seminal vesiculitis.
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Clinical presentation
The associated symptoms can be non-specific and are those typically associated with urinary tract infections:
- dysuria
- fever
- perineal or abdominal pain
- urinary retention
- ejaculation of purulent material
Pathology
Infectious agents such as Staphylococcus or E. coli have been associated with infection of the seminal vesicles.
Risk factors
- acute and chronic prostatitis (25%)
- urinary tract infection
- diabetes mellitus
- urological instrumentation
- urethral catheterization
Radiographic features
Ultrasound
- distended seminal vesicle with heterogeneous material inside
CT
- increase in volume and heterogeneous density of the seminal vesicle
- inflammatory changes of adjacent fat
- gas inside the vesicle may be seen
- peripheral enhancement on post-contrast images
MRI
Signal characteristics
- T1: iso-to-low signal
- T2: heterogeneous high signal
- DWI: high signal
- T1C+: peripheral enhancement
Treatment and prognosis
Antibiotics are the first line of treatment. Transperineal, transurethral or percutaneous drainage of the abscess is reserved for cases that do not respond to antibiotic therapy. Finally, surgical treatment is the last alternative for cases in which the other methods fail.
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