Vesiculitis – Causes, Symptoms, Treatment

// Published November 1, 2019 by James Washington

Vesiculitis is an acute or chronic disease of the male reproductive system, which is characterized by an inflammatory process in the seminal vesicles.

Anatomy and physiology of seminal vesicles

Seminal vesicles are located on the side of the vas deferens. The front wall of the paired glandular organ is in contact with the bladder, and the rear wall is in contact with the rectum.

Each seminal vesicle has the shape of an accordion (a strongly convoluted tubule), its length in this form is up to 5 cm. If the vesicles are flattened, the sizes of each reach 12 cm. The lower end of the seminal vesicle is pointed. It passes into the excretory duct. The latter ends with the vas deferens in the prostatic part of the urethra at the site of the seminal tubercle. On the way to the place, the ducts pass through the thickness of the prostate gland.

Seminal vesicles perform the following functions:

    • direct ejaculation process – during sexual intercourse, during ejaculation, the contents of the seminal vesicles and ducts are mixed with prostatic secretion and enter the urethra at the base of the seminal tubercle;
    • “Utilization” of sperm – after sexual arousal did not end with ejaculation, sperm return to the seminal vesicles from the ducts, where they are absorbed by spermiophages;
    • fructose production – a carbohydrate is an energy source to support the mobility and vitality of male germ cells. Due to the quantitative indicator of fructose, one can judge about androgenic saturation;
    • sperm protection – the seminal vesicles together with the reproductive cells produce a secret that envelops the sperm and, as it were, creates a film with a pH of 7.3. This protects the cell from the harmful effects of cervical mucus in the vagina and gives sperm resistance and resistance to the egg.

Causes of vesiculitis

Many factors can become a provocateur of the disease: vesiculitis can manifest itself, it can be a complication of the disease or its consequence.

The main causes of the disease are divided into stagnant and infectious. Infectious are also divided into specific and non-specific.

Congestive causes


    • congestion in the organs of the scrotum and pelvis: ischemia, atherosclerosis of the feeding arteries, endarteritis of aortic bifurcation;
    • diseases that provoke the accumulation and obstruction of the passage of the ejaculate through the natural ducts: prostate adenoma, prostate cancer, neoplasms of the bladder and rectal ampoule, fibrotic changes in the prostatic urethra;
    • mixed (combination of the above reasons).

Factors that provoke blood stasis and secretion in the vesicles can often be:

    • inflammatory diseases of the rectum;
    • interrupted sexual intercourse;
    • masturbation;
    • incomplete ejaculation in stressful situations;
    • hypothermia;
    • sedentary lifestyle, sedentary mode of work;
    • irregular sexual intercourse or prolonged abstinence.

Infectious causes

Infectious non-specific causes:

    • Candidiasis;
    • Viral
    • Bacterial
    • Mycoplasmal;
    • Chlamydial;
    • Gardnerellosis.

Infectious specific causes:

    • Gonorrhea;
    • Trichomonas;
    • Tuberculosis.

Other rarer causes may be autoimmune processes aimed at destroying the own cells of the seminal vesicles, an allergic reaction, stress, mechanical damage to the integrity of the scrotum and, accordingly, the seminal ducts and vesicles.

The clinical picture of vesiculitis

Depending on the duration of the disease, the types of the course of the disease are distinguished:

    • acute;
    • chronic.

Types of course differ in time (acute lasts up to a month, chronic – more than 3 months), symptoms and treatment methods.

Symptoms of acute and chronic vesiculitis are somewhat different, so we will consider each in detail. Sometimes it is difficult to recognize a disease, since it can have an erased clinic with weak immunity or hide behind the clinical picture of another disease.

Symptoms of acute vesiculitis

    • the disease begins with a sharp increase in total body temperature above 38 ° C
    • chills, weakness, fatigue, headaches – intoxication syndrome;
    • sharp pains in the inguinal region and perineum, which can migrate to the sacral region;
    • pain is often unilateral in nature (even in the presence of a bilateral process) due to the unequal degree of damage to the right and left seminal vesicles;
    • painful sensations increase with an overflowing bladder and an act of defecation, since at this time the contraction of the walls puts pressure on the inflamed organ. This once again provokes irritation of pain receptors;
    • uncomfortable ejaculation.

Symptoms of chronic vesiculitis

The clinic of the chronic process is more associated with impaired urination and a distortion of erectile function:

    • weak orgasms;
    • pain during sex and several hours after it;
    • increased pain during ejaculation;
    • resumption of pollutions;
    • dysuric disorders: a change in the quality of urine and its quantity, the appearance of discomfort;
    • constant aching pain in the sacrum.

Common symptoms

Other symptoms that accompany each type of vesiculitis and do not depend on the type of course:

    • azoospermia – a decrease in the normal sperm content in the ejaculate, which is the main cause of male infertility;
    • pyospermia – the presence of pus in the seminal fluid;
    • pyuria – excretion of urine with the presence of pyogenic masses;
    • noticeable drops of blood in semen.

Diagnosis of the disease

After a thorough examination and examination, the attending physician identifies the leading symptoms and outlines a preliminary diagnosis and further instrumental and laboratory research methods.

During an objective examination, a rectal examination is performed. With inflammation of the seminal vesicles, spindle-shaped seals over the prostate gland can be found.

Laboratory tests are immediately taken:

    • General blood analysis;
    • General urine analysis;
    • Semen analysis;
    • Investigation of seminal fluid.

A general blood test will show the presence of an inflammatory reaction in the body. This is evidenced by the increased erythrocyte sedimentation rate (more than 15), the shift of the leukocyte formula to the left (towards young leukocytes) and the increased amount of the total number of leukocytes.

A general urinalysis will reveal the presence of red blood cells, bacteria and white blood cells in the test fluid. Sometimes there is the presence of urate.

The most revealing and specific analysis in relation to vesiculitis is
spermogram (see “Semen analysis”) .

In the case of an inflammatory process, a spermogram will show:

  1. the presence of white blood cells and red blood cells in the ejaculate;
  2. decrease in sperm count;
  3. a change in the ratio of motile spermatozoa to immobile;
  4. the presence of pathogens;
  5. quantitative lack of fructose in seminal fluid.

For the study of seminal fluid, catheterization of the bladder is carried out with its further filling with an isotonic solution. After the flood, the seminal vesicles are massaged and at the end of the procedure they ask the patient to urinate. In the test urine, the same indicators are found as in the general analysis of urine, only in large quantities and directly from the testes.

Of the instrumental methods of research, vesiculography , ultrasound diagnostics, computed tomography and magnetic resonance imaging are used.

All these research methods will show an increase in seminal vesicles in size, thickening of the wall, and a change in the shape of the outer and inner surfaces. The difference lies in the clarity and detail of the changes described.

Vesiculitis treatment

Treatment features are available only for the degree of damage and neglect of the process. That is, acute and chronic vesiculitis are treated equally. But with complications of the chronic course, in addition to conservative therapy, doctors are forced to resort to surgical methods.

Treatment should begin immediately after the first symptoms appear in order to avoid unpleasant surgical procedures.

The doctor prescribes complex therapy. It should include etiological (aimed at eliminating the infectious agent or congestion), pathogenetic and symptomatic treatment.

To eliminate the pathogen, a broad-spectrum antibiotic is usually prescribed (macrolides, cephalosporins 3 generations, nitrofurans, protected penicillins, fluoroquinolones, carbopenems). If in the study of seminal fluid it was possible to identify the pathogen, then antibacterial drugs are selected individually for the microorganism and its reaction to various groups of drugs.

To eliminate stagnation, doctors use angioprotectors (improve blood rheology), non-steroidal anti-inflammatory drugs in tablet form and suppositories. Physiotherapy procedures (massage of the prostate and seminal vesicles), warm microclysters, and UHF therapy are very helpful. Elimination of stagnation of the secret will help to quickly get rid of the infection, since it does not remain in the cavity of the vesicles.

Ancillary therapy aims to reduce symptoms. Anesthetics are used, which are also used in tablet form and rectal suppositories. It is important to take a complex of vitamins and minerals, immunostimulants. This will help the body cope with the disease faster.

With the ineffectiveness of conservative therapy, it is supplemented with surgical treatment . Often used drainage of the cavity of the seminal vesicles and active washing with saline.

The prognosis for recovery is favorable. But in case of non-compliance with the doctor’s prescriptions, lack of necessary treatment or long breaks between antibiotic doses, relapse of the disease is possible.

Complications of vesiculitis and its prevention

In the absence of treatment and improperly selected therapy, prolonged inflammation, there may be the following complications:

    • empyema of seminal vesicles – it is dangerous to capture other organs in the process;
    • irreversible infertility;
    • decreased quality of orgasm;

To avoid such complications and the disease itself, you need to follow some rules:

    • protected sex and regular sex life;
    • active lifestyle, outdoor activities and sports;
    • avoid excessive drinking, smoking;
    • do not supercool;
    • avoid stress;
    • timely diagnosis and treatment of chronic infectious foci and diseases of the genitourinary system.