松田 忠久, 斉藤 雅人, 阿部 昌弘, 橋本 哲也, 小林 裕之, 渡辺 泱

Tadahisa MATSUDA, Masahito SAITOH, Masahiro ABE, Tetsuya HASHIMOTO, Hiroyuki KOBAYASHI, Hiroki WATANABE

京都府立医科大学泌尿器科

Department of Urology, Kyoto Prefectural University of Medicine

キーワード : Seminal vesiculitis, Transrectal linear scan, Interventional ultrasound

An interventional technique using a transrectal realtime linear scanner was applied to the perineal puncture for the seminal vesicles in 109 cases of seminal vesiculitis from 1981 to 1987. The aspiration of the seminal fluid and injection of antibiotics and/or steroid drugs into the vesicles were performed.
The diagnosis of seminal vesiculitis was based upon tenderness at the seminal vesicles by palpation, the dilatation of seminal vesicles on sonograms and symptoms of perineal discomfort, pain on ejaculation or others.
In 28 (26%) out of 109 cases, the seminal fluid was aspirated. The volume of fluid ranged from 0.5 to 12 ml. Microscopically, inflammatory cells were found in 5 out of 13 cases. In one case, staphylococcus aureus was cultured, while in another case, staphylococcus epidermidis was cultured.
Following the aspiration of the seminal fluid, antibiotics and/or steroid drugs were injected into the organ. Two weeks after the treatment, the changes in symptoms including tenderness at the seminal vesicles and ultrasonic findings were evaluated. Clinical symptoms improved in 63% and the dilatation and the deformity of seminal vesicles on the sonograms in 67%. In cases with the injection of antibiotics, clinical symptoms improved in 70% and the shape of seminal vesicles on the sonograms in 79%.
It appears that treatment by the injection of antibiotics and/or steroid drugs maybe effective for seminal vesiculitis. Though further evaluation will be necessary, this technique might be considered as a promising method for the treatment of seminal vesiculitis.