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We present three cases of ectopic ureteral orifice terminating in the seminal vesicle. The enlarged seminal vesicle, ipsilateral renal agenesis or hypoplasia and the absence of normal ureteral orifice are the triad of CT findings in this disease.
This study was conducted to quantify the relationships between in vivo measurements of testicular and seminal vesicle size and post mortem size of these organs in 30 Santa Gertrudis bulls. The in vivo measurements of testicles were obtained by transrectal ultrasonography and palpation per rectum, while scrotal circumference was measured by scrotal tape. Linear post mortem dimensions were obtained by direct measurements of the excised organs. Volume was assessed by water displacement while the testicles were weighed. Seminal vesicle length, determined by palpation, had the highest correlation with post mortem measurements (r = 0.70; P = 0.0001). Accurate estimation of the thickness of the vesicles (1.47 vs 1.55 cm for in vivo and post mortem, respectively) was performed by ultrasonograph. Of all seminal vesicle linear measurements, width had the highest correlations with volume measured by water displacement (r = 0.67; P = 0.0001 and r = 0.38; P = 0.04 for post mortem and in vivo, respectively). Testicular diameter was accurately measured by ultrasonography (5.54 vs 4.58 cm in vivo and post mortem, respectively) and was highly correlated (range r = 0.84 to 0.89; P = 0.0001) with post mortem measurements of testicular volume, weight and circumference. The correlation between scrotal circumference and diameter of the testicle was 0.75 (P = 0.0001). The correlations of testicular diameter measured by ultrasound with the post mortem measurements of testicular weight and circumference were similar to the correlations between scrotal circumference and those 2 post mortem measurements. We conclude that palpation of vesicle length is highly correlated with volume of the seminal vesicle in situ. Individual linear measurements do not seem to be an accurate predictor of the relativ size of the seminal vesicle. Furthermore, ultrasonography does not seem to be a more accurate measure of testicular size than scrotal circumference for evaluation of breeding soundness.
OBJECTIVE: To determine through preoperative serum PSA level, Gleason score on biopsy and percentage of fragments affected by tumor on biopsy, the probability of involvement of the seminal vesicles. MATERIALS AND METHODS: During the period between March 1991 to December 2002, we selected 899 patients undergoing radical prostatectomy for treatment of localized prostate adenocarcinoma. The analyzed preoperative variables were PSA, percentage of positive fragments and Gleason score on the biopsy. Pre-operative PSA was divided in scales from 0 to 4.0 ng/mL, 4.1 to 10 ng/mL, 10.1 to 20 ng/mL and > 20 ng/mL, Gleason score was categorized in scales from 2 to 6. 7 and 8 to 10, and the percentage of affected fragments was divided in 0 to 25%, 25.1% to 50%, 50.1% to 75%, and 75.1% to 100%. All these variables were correlated with the involvement of seminal vesicles in the surgical specimen. RESULTS: Of the 899 patients under study, approximately 11% (95% CI, [9% - 13%]) had involvement of seminal vesicles. On the multivariate analysis, when PSA was < or = 4, the Gleason score was 2 to 6, and less than 25% of fragments were involved on the biopsy, only 3.6%, 7.6% and 6.2% of patients respectively, had involvement of seminal vesicles. On the multivariate analysis, we observed that PSA, Gleason score and the percentage of involved fragments were independent prognostic factors for invasion of seminal vesicles. CONCLUSION: The preoperative variables used in the present study allow the identification of men with minimal risk (lower than 5%) if involvement of seminal vesicles.
Characterization of adrenergic receptors in membranes from the rat seminal vesicle was studied by radioligand binding assay. Seminal vesicle membranes contained saturable and high affinity binding sites for the beta-adrenergic receptor antagonist 3H-dihydroalprenolol (3H-DHA) and for the alpha-adrenergic antagonist 3H-prazosin. The observed order of potency for adrenergic agonists in competing for the 3H-DHA binding sites: isoproterenol > epinephrine congruent to salbutamol > norepinephrine indicates that these membrane receptors have the properties of beta 2-adrenergic receptors. alpha 1-Adrenergic receptors were defined mainly as alpha 1A subtypes by demonstrating their insensitivity to pretreatment with chlorethylclonidine and the different rank orders of antagonist affinities. No significant binding sites for the alpha 2-adrenergic receptor agonist 3H-clonidine were observed. The GTP-induced reduction in the affinity of alpha 1-adrenergic receptors for epinephrine was significantly reversed by the muscarinic cholinergic agonist carbachol. Atropine effectively antagonized this effect of carbachol on the competitive inhibition of 3H-prazosin binding by epinephrine in the presence of GTP, which suggests that muscarinic cholinergic receptors regulate the affinity of alpha 1-adrenergic receptors by modulating the effect of guanine nucleotides. The effect of GTP on decreasing the affinity of beta 2-adrenergic receptors was not influenced by the addition of carbachol.
There are differences in serum steroid concentrations during fetal life between male mice that develop between two male fetuses (2M males, with elevated testosterone) and between two female fetuses (0M males, with elevated estradiol). The present studies were undertaken to determine whether prior intrauterine position would influence the weight of seminal vesicles and preputial glands in adult male mice. To eliminate any potential differences between 2M and 0M males in circulating gonadal steroids, all males were castrated in adulthood and implanted with silastic capsules containing testosterone (T), dihydrotestosterone (DHT) or a combination of T and estradiol-17 beta (E2) or DHT and E2. Three weeks later, preputial glands were significantly heavier in 2M than 0M males after treatment with T but not DHT. Seminal vesicles were also significantly heavier (blotted wet weight) in 2M than 0M males after treatment with T. For 2M males, seminal vesicles weighed the same in response to treatment with T or DHT. However, relative to the effect of T, DHT significantly increased seminal vesicle weight in 0M males such that they were equivalent to weights in 2M males treated with T or DHT. This finding suggests that seminal vesicles in 0M males have lower concentrations of 5 alpha-reductase and, thus, a lower capacity to metabolize T to DHT which is required for normal seminal vesicle function. There were no significant effects of E2 (in combination with T or DHT) on seminal vesicle or preputial gland weight.
The effects of electrical field stimulation (at 1-100 Hz with 20-25 V, supramaximal, and 0.2 ms pulse duration, for 10-20 s), on tone and contractility of rat isolated seminal vesicle was studied, in the absence and presence of specific antagonists (phentolamine, 1 microM, alpha, beta-Me-ATP, 10 microM, and verapamil, 1 microM). The aim was to provide pharmacological evidence of the release of ATP, alongside NA, during electrical stimulation of the rat seminal vesicle. Electrical field stimulation of the rat seminal vesicle produced frequency-dependent contractions. At low rates of stimulation (1-20 Hz), only small tonic contractions were observed (0.3 g tension), whereas at high rates of stimulation (80-100 Hz), only phasic contractions (2-3 g) were seen. However, at intermediate rates of stimulation (e.g. 50 Hz), a biphasic response was produced: an initial fast, twitch-like response (phasic), followed by a slow tonic contraction. The phasic contraction was blocked by the stable analogue of ATP (alpha, beta-Me-ATP), which desensitizes P2-purinoceptors. The tonic contraction is adrenergic and was blocked by phentolamine. Verapamil reduced both types of contractions in this preparation and the block was unselective on tonic versus phasic contraction. It was concluded that electrical field stimulation produced frequency-dependent contractions tonic and phasic in the rat seminal vesicle. These responses were blocked by specific antagonists, suggesting the presence of different types of neurotransmitters released during electrical stimulation of the rat seminal vesicle.
A total of 12 men from a sperm donor bank underwent transrectal ultrasonography before and after ejaculation to investigate possible changes that could influence interpretation of seminal vesicle ultrasonography. The mean length of the seminal vesicles was 2.98 cm. before and 2.95 cm. after ejaculation. The anteroposterior diameter decreased only from 0.59 to 0.52 cm. Minimal differences were noted between the right and left seminal vesicles, and the greatest variation in size in an individual was only 3 mm. These results indicate that interpretation of seminal vesicle anatomy as seen by ultrasonography does not depend upon the temporal relationship to ejaculation.
Ultrasonically guided puncture of the prostate was carried out in 10 patients with prostatic disease. Biopsy of the aiming portion of the prostate was performed with more certainty and safety by this method than the conventional blind procedure. In the 15 cases having the suspicion of seminal vesicle disorder, the seminal vesicle was punctured under ultrasound control. By this procedure, the seminal vesicle fluid was safely and accurately obtained.
In some smears from prostatic aspirates we have observed atypical epithelial cells similar to those of seminal vesicles; however, the site of aspiration was nowhere close to the seminal vesicles. We presumed those cells corresponded to ejaculatory duct epithelium. To confirm this assumption, we compared the cytology of seminal vesicles and ejaculatory ducts based on smears obtained from 10 autopsy cases. The aspects analyzed were types and arrangements of the cells, cytoplasmic and nuclear features, presence of pigment, and background of the smear. The only differences observed were the greater amounts of proteinaceous material in smears from seminal vesicles and the presence of transitional epithelial cells in smears from ejaculatory ducts. We would like to make pathologists aware of atypical cells from ejaculatory ducts as a source of diagnostic difficulties in prostatic aspirates. This subject has received no attention in the literature.
PURPOSE: Congenital cysts of the seminal vesicles associated with ipsilateral renal abnormalities are rare. When they are symptomatic, open surgical excision has been the treatment of choice. We present our experience with laparoscopic management and provide a detailed literature review of this entity. MATERIALS AND METHODS: Since 1985, 3 patients with symptomatic seminal vesicle cysts and ipsilateral renal agenesis have been treated at our center. Open surgical excision was performed in 1 patient and laparoscopic management was performed in the other 2. RESULTS: Mean patient age was 35.7 years (range 30 to 42). Presenting symptoms were perineal pain in all 3 cases, dysuria in 2, irritable voiding in 2 and testicular pain in 1. Mean laparoscopic operative time was 195 minutes and mean estimated blood loss was 325 cc. Transabdominal or transrectal ultrasound was performed in 2 cases and computerized tomography was performed in all 3. CONCLUSIONS: Seminal vesicle cysts associated with ipsilateral renal agenesis are rare but they should be considered in men with otherwise inexplicable irritable voiding symptoms, perineal discomfort or other genitourinary complaint of unclear etiology. Evaluation should include digital rectal examination, transrectal and transabdominal ultrasound, computerized tomography and cystoscopy. Laparoscopy provides excellent intraoperative access and visualization with minimal postoperative morbidity. It is likely to become the treatment of choice for this rare developmental anomaly.
Cysts of the prostate and seminal vesicles are confusing abnormalities because they are uncommon and their origin is uncertain. Several approaches to diagnosis have been used, most recently CT and transrectal sonography. In this study, we investigated the value of MR imaging in the diagnosis of six cases of prostatic cyst and five cases of cysts of the seminal vesicles. All patients were symptomatic. T1- and T2-weighted spin-echo images were obtained in all cases; pathologic confirmation was available in four patients. MR images were analyzed prospectively without knowledge of clinical data or the results of other imaging procedures. In all cases, low- and high-signal masses were observed on T1- and T2-weighted images, respectively. The cysts were unilocular with a sharply defined margin, ranging from 0.5 to 3.0 cm in diameter. The thin wall was of low signal intensity on T2-weighted images. Our experience suggests that MR imaging is useful in demonstrating the liquid content of prostatic and seminal-vesicle cysts and in establishing their size and location.
PURPOSE: Cellular mechanisms of excitatory neuromuscular transmission in circular smooth muscles of the seminal vesicle were investigated. MATERIALS AND METHODS: Circular smooth muscles of the seminal vesicle of the guinea pig were isolated. Changes in membrane potential produced by transmural nerve stimulation were recorded using intracellular microelectrode techniques. Changes in the intracellular Ca ion concentration induced by transmural nerve stimulation were measured in preparations loaded with Ca indicator fura-PE3. Responses produced by bath applied norepinephrine and alpha,beta-methylene adenosine triphosphate (ATP) were also examined. RESULTS: Transmural nerve stimulation evoked excitatory junction potentials that triggered action potentials and also caused transient increases in [Ca2+] (Ca transients). Nifedipine abolished action potentials, leaving underlying excitatory junction potentials unchanged, and reduced the amplitude of Ca transients. Excitatory junction potentials were blocked by alpha,beta-methylene ATP or guanethidine but not by phentolamine. A train of transmural nerve stimulation evoked oscillatory changes in membrane potential and [Ca2+], which were abolished by phentolamine or inhibited by nifedipine. Nifedipine insensitive components were abolished by cyclopiazonic acid. Norepinephrine depolarized the membrane and elicited oscillatory potentials with an associated elevation in [Ca2+]. These responses were inhibited by nifedipine and abolished by additional application of cyclopiazonic acid. Transient depolarization with an associated increase in [Ca2+] was elicited by alpha,beta-methylene ATP and [Ca2+] responses but no potential changes were inhibited by nifedipine. CONCLUSIONS: Circular smooth muscles of the guinea pig seminal vesicle receive a projection of sympathetic nerves that release norepinephrine to initiate slow depolarization through the activation of alpha-adrenoceptors. These nerves also release ATP to elicit excitatory junction potentials. Neurally released norepinephrine and ATP are increased [Ca2+] by the influx of Ca2+ through L-type Ca2+ channels and also by the release of Ca2+ from internal stores.
OBJECTIVE: Seminal vesicle invasion (pT3b) is a known factor of poor prognosis after radical prostatectomy. The authors retrospectively studied the course of stage pT3b tumours, and the clinical, laboratory and histological factors that could influence this course. METHODS: From 1988 to 2001, out of a total of 538 radical prostatectomies, 62 (11.5%) cases with isolated seminal vesicle invasion were analysed according to the Stanford technique. Half-yearly postoperative surveillance was based on physical examination and PSA assay. Progression was defined as PSA greater than 0.2 ng/ml or when complementary treatment was performed. Actuarial progression-free survival was studied according to the Kaplan-Meier method. Actuarial survivals were compared by the Log-rank method, and a difference was considered to be significant for p < 0.05. Multivariate analysis using the Cox model was performed. RESULTS: The mean Gleason score of the radical prostatectomy specimen was 6.9, and the mean tumour volume was 2.7 cm3. Forty eight (77.4%) specimens showed capsular effraction and 33 (53.2%) had positive surgical margins. The 5-year laboratory progression-free survival was 16%. A low preoperative PSA, a radical prostatectomy specimen Gleason score less than 7 and capsular effraction were factors of good prognosis on multivariate analysis. CONCLUSION: Prostatic tumours with seminal vesicle invasion have a high risk of progression after radical prostatectomy. A preoperative PSA level less than 10 ng/ml, a Gleason score of the operative specimen less than 7 and effraction of the prostatic capsule can be used to identify a subpopulation of patients with a better prognosis.
We examined the developmental profile of a kazal-type trypsin inhibitor (P12) of Mr 6126 in mouse seminal vesicle, characterized its binding sites on the surface of sperm, and assessed its effect on Ca2+ uptake by spermatozoa. Among the genital tracts of adult mice, P12 was found only in the male accessory glands including seminal vesicle, coagulating gland, and prostate. It was immunolocalized on the luminal epithelium of the primary and secondary folds in both the seminal vesicle and coagulating gland, and on the folds projecting into the lumen of the glandular alveolus in the prostate. The protein and its RNA message in seminal vesicle did not appear in the prepubertal period, but expression coincided with maturation. Castration of adult mice resulted in cessation of P12 expression. Treatment of the castrated mice with testosterone propionate in corn oil restored the protein expression in the seminal vesicle. Spermatozoa collected from caudal epididymis were devoid of P12. Cytochemical study illustrated a P12-binding region on the anterior acrosomes of cells preincubated with P12. Analysis of equilibrium data from the binding assay using 125I-P12 with a Scatchard plot showed a single type of P12-binding sites on sperm, with an apparent dissociation constant of 70.15 +/- 5.25 nM and the capacity of 1.49 +/- 0.06 x 10(6) binding sites/cell. The protein could serve as a calcium transport inhibitor to suppress a great extent of Ca2+ uptake by spermatozoa. The immunohistochemical staining patterns of testis revealed that the P12-binding sites appeared on postmeiotic cells such as spermatids and spermatozoa, but were absent in Leydig cells, Sertoli cells, spermatogonia, and spermatocytes in seminiferous tubules.
The effects of chronic alcohol ingestion on the secretory epithelium of the seminal vesicle were studied in rats (Rattus norvegicus). Male adult albino Wistar rats were divided into two groups: alcoholic and control. Tips of the seminal vesicle were removed and prepared for light and electron microscopy. Ultrastructural observations on the epithelial cells of the seminal vesicle showed reduced epithelial cell size, decreased apical secretory vacuoles, irregularly shaped nuclei with deep infoldings, increased lipid droplets and dense bodies, a small number of microvilli covering the cell surface, and signs of degeneration. In addition to the hormonal effects, alcohol may act on the secretory epithelium of the seminal vesicle.
PURPOSE: We identify prognostic factors in patients with seminal vesicle involvement and negative lymph nodes following radical prostatectomy for clinically localized prostate cancer. MATERIALS AND METHODS: A total of 93 patients who underwent radical prostatectomy and had seminal vesicle invasion without lymph node metastasis were evaluated. Patients who underwent neoadjuvant/adjuvant hormonal or radiation therapy were excluded from study. Preoperative serum prostate specific antigen (PSA), biopsy and radical prostatectomy specimen Gleason score, surgical margin status, presence of extraprostatic extension and evidence of biochemical disease progression were determined prospectively. Biochemical failure was defined as a single serum PSA elevation greater than 0.4 ng./ml. RESULTS: The presence of positive surgical margins (p = 0.001), and Gleason score 7 or higher from preoperative biopsies (p = 0.03) and from the radical prostatectomy specimen (p = 0.01) were significant predictors of disease progression at a median followup of 43.3 months. Patients with preoperative PSA less than 10 ng./ml. had a better disease-free survival (p = 0.07). On multivariate analysis, after adjusting for biopsy Gleason score, prostatectomy Gleason score and serum PSA, positive surgical margins remained a statistically significant predictor of disease progression (p = 0.002). CONCLUSIONS: Surgical margin status is an independent predictor of disease recurrence in patients with seminal vesicle involvement and negative lymph nodes following radical prostatectomy. Serum PSA 10 ng./ml. or greater and specimen Gleason score 7 or greater also were adverse prognostic factors in these patients. Conversely, patients with negative surgical margins and lymph nodes have a better prognosis than previously expected, despite seminal vesicle invasion.
PURPOSE: We evaluated the characteristics of seminal vesicle amyloidosis (SVA) associated with hemospermia by immunohistochemistry and magnetic resonance imaging (MRI) as well as the clinical course of hemospermia. MATERIALS AND METHODS: Of 56 patients with hemospermia 12 underwent transperineal biopsy of the seminal vesicle under transrectal ultrasound monitoring. SVA was proved in 4 men 48 to 59 years old by histological and immunohistochemical examinations of specimens obtained by biopsy. Two men presented with the first episode of hemospermia and 2 presented with recurrent hemospermia. MRI at 1.5 Tesla was performed while hemospermia persisted and after its resolution. Patients were followed for 10 to 86 months with regard to the duration of hemospermia, the time of its resolution and its recurrence. RESULTS: Amyloid deposits in the subepithelial tissue of the seminal vesicles were permanganate sensitive, and positive for lactoferrin and the amyloid P component but negative for amyloid A protein, lambda and kappa chains, and beta2-microglobulin. The seminal vesicles with obvious intravesicular hemorrhage on needle puncture were hyperintense on T1-weighted images. After hemospermia resolution T1-weighted images became diffusely hypointense. T2-weighted images were of low intensity, representing amyloid deposits. Hemospermia resolved spontaneously in all patients in an average of 14 months. Although disease recurred in 1 patient after 8 months of resolution, it disappeared after 11 months of recurrence. CONCLUSIONS: Localized SVA with hemospermia shows hypointensity on T2-weighted MRI. Hemospermia is spontaneously resolved with the transition from hyperintense to hypointense T1-weighted MRI.
Male (C57BL/6 x DBA)F1 hybrid mice were castrated on day 60 after birth; two pituitaries from 60-day-old female mice were immediately grafted under the capsule of the left kidney in half of the castrated mice to induce hyperprolactinemia. The seminal vesicles in the absence of androgen treatment were examined 15, 22, 30 and 60 days after castration with or without grafting. Significant increases in the weight (1.3-1.4-fold), DNA content (1.2-1.3-fold) and labeling index of epithelial cells (4-10-fold) of the seminal vesicles were found in mice with pituitary grafts compared to mice without grafts on days 15-30 after castration but not on day 60 after castration. Such stimulatory effects of hyperprolactinemia on mouse seminal vesicle cells were also observed on day 15 after castration plus adrenalectomy. Cell loss from the seminal vesicles was found to be similar in castrated mice with and without the grafts. The present findings demonstrate that hyperprolactinemia induces an increase in DNA synthesis of epithelial cells in the seminal vesicles until 30 days after castration and results in a significant delay of castration-induced involution of the weight and DNA content of the seminal vesicles for 1 month. However, the delay with increased epithelial cell growth by hyperprolactinemia disappeared 60 days after castration.