Function of seminal vesicles and their role on male fertility

The present review has been designed to update the recent developments on the function of seminal vesicles andtheir role on male fertility. It is indicated that the true corrected fructose level is a simple method for the assessment ofthe seminal vesicular function. Measurement of seminal fructose used universally as a marker of the seminal vesiclefunction is not an appropriate approach due to its inverse relationship with the sperm count. The true corrected fructosedefined as [log. motile sperm concentration] multiplied by [seminal fructose concentration] has been shown to be abetter marker of the seminal vesicle function. Seminal vesicular secretion is important for semen coagulation, sperm motility, and stability of sperm chromatinand suppression of the immune activity in the female reproductive tract. In conclusion, the function of seminal vesicle is important for fertility. Parameters as sperm motility, sperm chro-matin stability, and immuno-protection may be changed in case of its hypofunction. (Asian J Androl 2001 Dec; 3:251 -258)

Seminal vesicles and diabetic neuropathy： ultrasound evaluation in patients with couple infertility and different levels of glycaemic control

The aim of this study was to evaluate the ultrasound characteristics of the seminal vesicles （SVs） of infertile patients with diabetes mellitus （DM） and diabetic neuropathy （DN） and to investigate possible changes in ultrasound characteristics related to glycaemic control. To accomplish this, 45 infertile patients with type 2 DM and symptomatic DN were selected. Twenty healthy fertile men and 20 patients with idiopathic oligoasthenoteratozoospermia without DM represented the control groups. DM patients were arbitrarily divided into three groups according to glycaemic control level （A=glycosylated haemoglobin 〈7%; B =glycosylated haemoglobin between 7% and 10%; C=glycosylated haemoglobin 〉 10%）. Patients underwent prostate-vesicular transrectal ultrasonography and sperm analysis. The following SV ultrasound parameters were recorded： （i） body antero-posterior diameter （APD）; （ii） fundus APD; （iii） parietal thicknesses of the right and left SVs; and （iv） the number of polycyclic areas within both SVs. We then calculated the following parameters： （i） fundus/body （F/B） ratio; （ii） difference of the parietal thickness between the right and the left SV; and （iii） pre- and post-ejaculatory APD difference. All DM patients had a higher FIB ratio compared to controls （P〈0.05）. Group C had a higher FIB ratio compared to the other DM groups （P〈0.05）. All DM patients had a lower pre- and post-ejaculatory difference of the body SV APD compared to controls （P〈0.05）. Groups A and B had a similar pre- and post-ejaculatory difference of the body SV APD, whereas this difference was lower in Group C （P〈0.05）. In conclusion, infertile DM patients with DN showed peculiar SV ultrasound features suggestive of functional atony, and low glycaemic control was associated with greater expression of these features.

The performance of transrectal ultrasound in the diagnosis of seminal vesicle defects： a comparison with magnetic resonance imaging

Obstructive azoospermia （OA） is one of the most common causes of male infertility. Transrectal ultrasound （TRUS） has been used to diagnose OA for many years. From 2009 to 2013, we evaluated a prospective cohort of 1249 patients with suspected OA using TRUS. It was found that dilation of the ejaculatory duct （ED） （29.9%, 374/1249） was the most common cause of OA, followed by seminal vesicle （SV） abnormalities （28.5%, 356/1249）. A total of 237 patients were diagnosed with congenital defects （agenesis and/or hypoplasia） of the SV, constituting more than half of the cases of SV disease in OA （19.0%, 237/1249）. In contrast to ED, congenital defects of the SV could not be corrected with surgical treatment. Therefore, it is meaningful to compare TRUS and magnetic resonance imaging （MRI） for accurate diagnosis of SV defects. Among our patients, 30 with agenesis or/and hypoplasia of the SV on TRUS were further evaluated using pelvic MRI within 2 years, with the objective of verifying the TRUS results. The concordance rate for diagnosing congenital defects of the SV was 73.3% （22/30）. We concluded that TRUS is a reliable and convenient method for diagnosing agenesis or hypoplasia of the SV in OA patients with a high concordance with MRI while MRI is useful in patients with inconclusive TRUS findings.

Congenital agenesis of seminal vesicle

Congenital agenesis of the seminal vesicle （CASV） is frequently associated with congenital absence of the vas deferens （CAVD） or ipsilateral congenital vasoureteral communication. We reported two cases of a rare condition that the vas deferens open ectopically into Mullerian duct cyst associated with agenesis of the ipsilateral seminal vesicle. The diagnosis was confirmed by vasography. Transurethral unroofing of the Mullerian duct cyst was performed in both patients with favourable results, however, assisted reproductive technology （ART） was still necessary for them to father children.

Laparoscopic treatment of a calcium fluorophosphate stone within a seminal vesicle cyst

Stones in the seminal vesicles are extremely rare. We present a 62-year-old patient with a stone within a seminal vesicle cyst, who was cured by laparoscopic treatment. The operative time was 80 rnin, and the estimated blood loss was 90 mL. Scanning electron microscope examination of the stone showed a compact crystal image externally and sparse spherical crystal structure in kernel. Composition of the stone was calcium fluorophosphate on X-ray diffractometer. The follow-up time was 15 months with no recurrence of cyst or stone. To our knowledge, this case is the first to describe laparoscopic removal of a stone within a seminal vesicle cyst, and the first to describe calcium fluorophosphate as the composition of seminal vesicle stones. （Asian JAndro12008 Mar; 10： 337-340）

Sexual selection affects the sizes of the mammalian prostate gland and seminal vesicles

The accessory reproductive glands of male mammals contribute the bulk of the secretions in which spermatozoa are transported to the female tract during copulation. Despite their morphological diversity, and the chemical complexity of their products, little is known about the possible effects of sexual selection upon these glands in mammals. Here we consider the seminal vesicles and prostate glands in a sample of 89 species and 60 genera representing 8 Orders of mammals. The sizes of the accessory glands are analysed in relation to body weight and testes weight. Both the seminal vesicles size and prostate size （corrected for body weight） correlate positively with relative testes size in this sample; this finding remains highly significant after application of procedures to correct for possible phylogenetic biases in the data set. The accessory reproductive glands are also significantly larger in those mammals which have large relative testes sizes, and in which the likelihood of sperm competition is greatest. These results support the hypothesis that sexual selection has played an important role in the evolution of the mammalian prostate gland and seminal vesicles.

Rectoseminal vesicle fistula after radical surgery for rectal cancer:Four case reports and a literature review

BACKGROUND A rectoseminal vesicle fistula(RSVF)is a rare complication after anterior or low anterior proctectomy for rectal cancer mainly due to anastomotic leakage(AL).Limited literature documenting this rare complication is available.We report four such cases and review the literature to investigate the etiology,clinical manifestations,and the diagnostic and treatment methods of RSVF in order to provide greater insight into this disorder.CASE SUMMARY Four cases of RSVF were presented and summarized,and a further 12 cases selected from the literature were discussed.The main clinical symptoms in these patients were pneumaturia,fever,scrotal swelling and pain,anal pain,orchitis,diarrhea,dysuria,epididymitis and fecaluria.Imaging methods such as pelvic Xray,computed tomography(CT),sinus radiography,barium enema and other techniques confirmed the diagnosis.CT was the imaging modality of choice.In cases presenting with reduced levels of AL,minimal surrounding inflammation,and controlled infection,the RSVF was conservatively treated by urethral catheterization,antibiotics administration and parenteral nutrition.In cases of severe RSVF,incision and drainage of the abscess or fistula and urinary or fecal diversion surgery successfully resolved the fistula.CONCLUSION This study provides an extensive analysis of RSVF,and outlines,summarizes and examines the causes,clinical manifestations,diagnostic procedures and treatment options,in order to prevent misdiagnosis and treatment errors.

Incidental seminal vesicle amyloidosis observed in diagnostic prostate biopsies--are routine investigations for systemic amyloidosis warranted？

Seminal vesicle （SV） amyloidosis is a well-documented histological entity, but it is observed infrequently. Its incidence is on the rise, which is probably related to the increasing use of prostate biopsies to investigate patients with elevated serum prostate-specific antigen levels. Here, we report seven cases of incidental SV amyloidosis over a 3-year period and consider their relationship to the previously suggested aetiological factors. Based on our series, we conclude that incidental localized SV amyloidosis observed in diagnostic prostate biopsies does not warrant formal investigations for systemic amyloidosis.

POSVP21, a major secretory androgen-dependent protein from sand rat seminal vesicles, identified as a transgelin

The seminal vesicles of adult sand rat contain a major secretory protein band （MW 21 kDa） designated as Psammomys obesus seminal vesicles protein of 21 kDa （POSVP21）. This protein is abundant in secretions, regulated by androgens and also present in the vaginal plug. POSVP21 accounts for over 22.3% of soluble proteins from homogenate during the breeding season, 13.3% during the middle season and 5.3% during the hormonal regression season. It is absent during the non-breeding season. POSVP21 is localized in the cytoplasm of epithelial cells and in secretory products in the lumen. It presents an immunological homology with two epididymal proteins with the same molecular weight and a high degree of homology with transgelin from rat （Rattus norvegicus）.

Solitary seminal vesicle metastasis from ileal adenocarcinoma presenting with hematospermia:A case report

BACKGROUND Although metastatic adenocarcinoma of the ileum is not uncommon,solitary metastasis to the seminal vesicle has not been reported.We report a patient with recurrent hematospermia diagnosed with metastasis to the seminal vesicle following ileal adenocarcinoma resection,his subsequent management and outcome.CASE SUMMARY A 46-year-old man presented with recurrent episodes of painless hematospermia.This was not associated with any lower urinary tract symptoms.He had a past medical history of ileal tumor at the terminal ileum with solitary mesenteric lymph node metastasis on presentation,and underwent partial ileectomy and lymphadenectomy 4 years ago.Subsequent investigations included positronemission tomography and computed tomography imaging confirmed the very unusual diagnosis of a solitary tumor at the left seminal vesicle.Laparoscopic leftsided vesiculectomy was carried out.Histological analysis with immunohistochemistry showed that CDX-2 was positive and CK7 was negative,and the appearance was consistent with the diagnosis of recurrent metastatic adenocarcinoma of his previously treated intestine primary.The patient had an uneventful post-operative recovery.He received adjuvant chemoradiotherapy following surgery.He remained asymptomatic until he developed multiple bone and pulmonary metastases one year after surgery.CONCLUSION Clinicians should be aware of hematospermia as the first symptom of metastatic recurrence in patients with a history of ileal adenocarcinoma.

Primary seminal vesicle adenocarcinoma with a history of seminal vesicle cyst:A case report and review of literature

BACKGROUND Primary seminal vesicle adenocarcinoma is a rare malignancy that is difficult to diagnose.CASE SUMMARY A 54-year-old man with an 18-year history of a seminal vesicle cyst presented with worsening hematospermia that had persisted for one month.Dynamic contrast-enhanced computed tomography and pelvic magnetic resonance imaging indicated a mass with a cystic-solid component.Robot-assisted seminal vesicle tumor resection was performed,and primary seminal vesicle adenocarcinoma was confirmed pathologically.The patient received pelvic radiotherapy for six weeks,and to date,no evidence of recurrence has been found.CONCLUSION Seminal vesicle cysts should be monitored long-term.Seminal vesicle adenocarcinoma presents with non-specific symptoms and can be diagnosed by immunohistochemistry.

Acute diffuse peritonitis secondary to a seminal vesicle abscess:A case report

BACKGROUND Seminal vesicle abscess(SVA)is the manifestation of a relatively rare urinary system infection.In response to urinary system inflammation,an abscess forms in special locations.However,acute diffuse peritonitis(ADP)induced by SVA is unusual.CASE SUMMARY We report a case of a left SVA in a male patient complicated with pelvic abscess,ADP,multiple organ dysfunction syndrome,infectious shock,bacteremia,and acute appendiceal extraserous suppurative inflammation as a result of a long-term indwelling urinary catheter.The patient received a course of morinidazole+cefminol antibiotics but showed no obvious relief,so the perineal SVA underwent puncture drainage and abdominal abscess drainage+appendectomy was performed.The operations were successful.After the operation,anti-infection,anti-shock,and nutritional support treatments were continued and various laboratory indicators were regularly reviewed.The patient was discharged from the hospital after recovery.This disease is a challenge for the clinician because of the unusual spreading path of the abscess.Moreover,appropriate intervention and adequate drainage of abdominal and pelvic lesions are necessary,especially when the primary focus cannot be determined.CONCLUSION The etiology of ADP varies,but acute peritonitis secondary to SVA is very rare.In this patient,the left SVA not only affected the adjacent prostate and bladder but also spread retrogradely through the vas deferens,forming a pelvic abscess in the loose tissues of the extraperitoneal fascia layer.Inflammation involving the peritoneal layer led to ascites and pus accumulation in the abdominal cavity,and appendix involvement led to extraserous suppurative inflammation.In clinical practice,surgeons need to consider the results of various laboratory tests and imaging examinations to make comprehensive judgments involving the diagnosis and treatment plan.

A Pelvic Free-Floating “Intraperitoneal Mice” Mimicking Seminal Vesicle Malignancy: A Case Report

Peritoneal loose bodies or “peritoneal mice” are rare well circumscribed benign masses composed of free-floating organized fat necrosis. They are usually asymptomatic and found as “incidentalomas” during Imaging. Their pathogenesis is not well known. We report a rare case of giant intraperitoneal mice which was clinically misdiagnosed as left seminal vesicle malignancy. A review of the literature is also presented.

Transurethral seminal vesiculoscopy in the diagnosis and treatment of seminal vesicle stones

Background Seminal vesicle stones are one of the main causes of persistent hemospermia. Treatment requires removal of the stone, generally through open vesiculectomy. The purpose of this study was to apply a transurethral seminal vesiculoscopy for diagnosis and treatment of the seminal vesicle stones with an ureteroscope. We assessed whether this transurethral endoscopic technique is feasible and effective in the diagnosis and treatment of the seminal vesicle stones with intractable hemospermia. Methods Totally 12 patients with intractable hemospermia underwent transurethral seminal vesiculoscopy through the distal seminal tracts using a 7.3-French rigid ureteroscope. Age of patients ranged from 25 to 57 years （mean age （43.7±10.5） years）. The patients＇ symptoms ranged in duration from 4 to 180 months （mean duration （47.8±45.3） months）. All patients underwent transrectal ultrasonography, pelvic computed tomography or magnetic resonance imaging before the operation. Positive imaging findings were observed in patients with seminal vesicle stones and dilated seminal vesicle size. A 7.3-French rigid ureteroscope entered the lumen of the verumontanum, and then the seminal vesicle under direct vision. Seminal vesicle stones were found unilaterally in 11 cases and bilaterally in one case. Results All 12 patients successfully underwent transurethral seminal vesiculoscopy. The seminal vesicle interior with single or multiple yellowish stones ranging from 1 to 5 mm in diameter was clearly visible. All the stones were easily fragmented and endoscopically removed using a grasper. The operative time was 30 to 120 minutes （mean （49±22） minutes）. The mean follow-up period was （6.9±3.0） months （range 3-13 months）. Symptoms of hemospermia disappeared after one month in 10 patients and after three months in two patients. Three patients with painful ejaculation could completely be relieved postoperation. There was also improvement in one patient with erectile dysfunction. There were no postoperative complications. Conclusions Transurethral seminal vesiculoscopy is safe and effective in the diagnosis and treatment of seminal vesicle stones. This endoscopic technique can be performed with minimal complications.

Relation of size of seminal vesicles on ultrasound to premature ejaculation

Myriad biological factors have been proposed to explain premature ejaculation （PE）. However, data correlating PE with seminal vesicles （SVs） are sparse. The study aimed to evaluate the relationship between the size of SV and PE. The cross-sectional study included 44 outpatients with PE and 44 volunteers without PE, and the size of SV was compared. Self-estimated intravaginal ejaculatory latency time, the Premature Ejaculation Diagnostic Tool （PEDT）, the International Index of Erectile Function-15, and the National Institutes of Health-Chronic Prostatitis Symptom Index were used for assessment of symptoms. Compared to the control group, the PE group had significantly higher mean anterior-posterior diameter （APD） of SV （P 〈 0.001）. The optimal mean APD of SV cutoff level was 9.25 mm for PE. In the PE group, PEDT was also higher with a mean APD of SV ≥9.25 mm compared with mean APD of SV 〈9.25 mm. PEDT was significantly correlated with the mean APD of SV （r = 0.326, P = 0.031）. The seminal plasma proteins were compared between six PE and six matched control cases by mass spectrometry and it was shown that 102 proteins were at least 1.5-fold up- or down-regulated. Among them, GGT1, LAMC1, and APP were significantly higher in the PE group. These results indicated that men with a larger mean APD of SV might have a higher PEDT score. Transrectal ultrasound of SV should be considered in the evaluation of patients with premature ejaculation. SV might be a potential target for the treatment of patients with PE and ultrasound change in SV.

Clinical outcomes of transperitoneal laparoscopic unroofing and fenestration under seminal vesiculoscopy for seminal vesicle cysts

Symptomatic seminal vesicle cysts （SVCs）, especially those of a large size, can be removed by surgical treatments. Currently, open surgeries for SVC are rarely performed due to their extensive surgical trauma, and minimally invasive surgical therapies for treating seminal vesicle cysts are still in the early stages. In addition, relevant studies are mostly confined to case reports. In this study, we retrospectively reviewed 53 patients who had received transperitoneal laparoscopic unroofing or fenestration under seminal vesiculoscopy for SVC in our institution. Both surgeries decreased the cyst volume to a significant extent; however, according to the remnant lesion size after rechecking images, seminal vesiculoscopic fenestration tended to have a higher recurrence than laparoscopic unroofing. Regarding complications, two individuals in the laparoscopic unroofing group experienced ureteral injury and rectal injury, while patients in the fenestration group only had temporary hemospermia, which indicates that fenestration surgery tends to have less severe complications than laparoscopic unroofing. There was no solid evidence confirming semen improvement after these surgical therapies in our study. Future studies with a prospective design, larger sample size, and longer follow-up period are required to verify and further explore our findings.

Phase 1 clinical trial demonstrated that MUC1 positive metastatic seminal vesicle cancer can be effectively eradicated by modified Anti-MUC1 chimeric antigen receptor transduced T cells

Recent progress in chimeric antigen receptor-modified T-cell(CAR-T cell) technology in cancer therapy is extremely promising, especially in the treatment of patients with B-cell acute lymphoblastic leukemia. In contrast, due to the hostile immunosuppressive microenvironment of a solid tumor, CAR T-cell accessibility and survival continue to pose a considerable challenge, which leads to their limited therapeutic efficacy. In this study, we constructed two anti-MUC1 CAR-T cell lines. One set of CAR-T cells contained SM3 single chain variable fragment(sc Fv) sequence specifically targeting the MUC1 antigen and co-expressing interleukin(IL) 12(named SM3-CAR). The other CAR-T cell line carried the SM3 sc Fv sequence modified to improve its binding to MUC1 antigen(named p SM3-CAR) but did not co-express IL-12. When those two types of CAR-T cells were injected intratumorally into two independent metastatic lesions of the same MUC1+ seminal vesicle cancer patient as part of an interventional treatment strategy, the initial results indicated no side-effects of the MUC1 targeting CAR-T cell approach, and patient serum cytokines responses were positive. Further evaluation showed that p SM3-CAR effectively caused tumor necrosis, providing new options for improved CAR-T therapy in solid tumors.

Neurilemmoma of a seminal vesicle

Neurilemmoma, also named Schwannoma, is usually a benign tumour composed of Schwann cells. It is commonly located in the retroperitoneum, mediastinum, head and neck, and is rarely seen in the genitourinary organs. Only cases of neurilemmoma originating from the seminal vesicle have been reported. Here we present the third case.

mpact of antioxidants on seminal vesicles function ind fertilizing potential in diabetic rats

Diabetes mellitus significantly affects the male reproduction and sexual function. In the present study, we investigated the diabetes-induced dysfunction of seminal vesicles （SVs） in the diabetes-rat model and the role of antioxidants. Streptozotocin-induced diabetes after 4 weeks caused smaller size of the organs, hypercontractility, histological abnormalities, increased concentrations of malondialdehyde in the serum and tissue, overexpression of oxidative stress markers, and cleaved caspase-3 as identified by immunohistochemistry in the SVs. In addition, diabetes resulted in deceased levels of serum testosterone and no newborns after the mating studies. Antioxidants significantly normalized all the above parameters, except for the severely decreased serum testosterone levels and the negative outcome of the mating studies. The present study gives evidence for the important role of diabetes-induced oxidative stress in the function and structure of these androgen-dependent organs. Antioxidants may be a promising supplementary therapy for diabetic male patients to alleviate ejaculatory disorders but alone is not efficient treatment for the mitigation of infertility.

Added value of shear-wave elastography in the prediction of extracapsular extension and seminal vesicle invasion before radical prostatectomy

The purpose of this study was to analyze the value of transrectal shear-wave elastography(SWE)in combination with multivariable tools for predicting adverse pathological features before radical prostatectomy(RP).Preoperative clinicopathological variables,multiparametric magnetic resonance imaging(mp-MRI)manifestations,and the maximum elastic value of the prostate(Emax)on SWE were retrospectively collected.The accuracy of SWE for predicting adverse pathological features was evaluated based on postoperative pathology,and parameters with statistical significance were selected.The diagnostic performance of various models,including preoperative clinicopathological variables(model 1),preoperative clinicopathological variables+mp-MRI(model 2),and preoperative clinicopathological variables+mp-MRI+SWE(model 3),was evaluated with area under the receiver operator characteristic curve(AUC)analysis.Emax was significantly higher in prostate cancer with extracapsular extension(ECE)or seminal vesicle invasion(SVI)with both P<0.001.The optimal cutoff Emax values for ECE and SVI were 60.45 kPa and 81.55 kPa,respectively.Inclusion of mp-MRI and SWE improved discrimination by clinical models for ECE(model 2 vs model 1,P=0.031;model 3 vs model 1,P=0.002;model 3 vs model 2,P=0.018)and SVI(model 2 vs model 1,P=0.147;model 3 vs model 1,P=0.037;model 3 vs model 2,P=0.134).SWE is valuable for identifying patients at high risk of adverse pathology.