Editing Seminal vesicles (section)

==Clinical significance==

=== Disease ===
Diseases of the seminal vesicles as opposed to that of prostate gland are extremely rare and are infrequently reported in the medical literature.<ref>Dagur G, Warren K, Suh Y, Singh N, Khan SA. Detecting diseases of neglected seminal vesicles using imaging modalities: A review of current literature. Int J Reprod Biomed. 2016;14(5):293-302.</ref>

<!-- Structural and anatomical problems -->[[Congenital anomalies]] associated with the seminal vesicles include failure to develop, either completely ([[agenesis]]) or partially ([[hypoplasia]]), and [[cyst]]s.<ref name="smiths" /><ref name="causes" /> Failure of the vesicles to form is often associated with absent vas deferens, or an abnormal connection between the vas deferens and the ureter.<ref name="Grays2016" /> The seminal vesicles may also be affected by [[cyst]]s, [[amyloidosis]], and [[Calculus (medicine)|stones]].<ref name="smiths" /><ref name="causes" /> Stones or cysts that become infected, or obstruct the vas deferens or seminal vesicles, may require surgical intervention.<ref name="Smiths2019" />

<!-- Vesiculitis -->Seminal vesiculitis (also known as spermatocystitis) is an inflammation of the seminal vesicles, most often caused by bacterial infection.<ref>{{Cite web |title=Is seminal vesiculitis a discrete disease entity? Clinical and microbiological study of seminal vesiculitis in patients with acute epididymitis. |date=4 July 2023 |url=https://vitaliboost.com/journal/is-seminal-vesiculitis-a-discrete-disease-entity-clinical-and-microbiological-study-of-seminal-vesiculitis-in-patients-with-acute-epididymitis/ }}</ref> Symptoms can include vague back or lower abdominal pain; pain of the penis, scrotum or peritoneum; painful ejaculation; [[Haematospermia|blood in the semen]] on ejaculation; irritative and obstructive voiding symptoms; and impotence.<ref>{{cite book|last1=Zeitlin|first1=S. I.|title=Textbook of Prostatitis|last2=Bennett|first2=C. J.|date=1 November 1999|publisher=CRC Press|isbn=9781901865042|editor-last=Curtis Nickel|editor-first=J.|pages=219–225|chapter=Chapter 25: Seminal vesiculitis|chapter-url=https://books.google.com/books?id=YiZz_xDk7rkC&pg=PA219}}</ref> Infection may be due to [[sexually transmitted infection]]s, as a complication of a procedure such as prostate biopsy.<ref name="Smiths2019" /> It is usually treated with [[antibiotic]]s. If a person experiences ongoing discomfort, transurethral seminal vesiculoscopy may be considered.<ref name="pmid21696400">{{cite journal |author=La Vignera S |date=October 2011 |title=Male accessory gland infection and sperm parameters |journal=International Journal of Andrology |volume=34 |pages=e330–47 |doi=10.1111/j.1365-2605.2011.01200.x |pmid=21696400 |issue=5pt2|doi-access=free }}</ref><ref name="pmid24391141">{{cite journal |author1=Bianjiang Liu |author2=Jie Li |author3=Pengchao Li |author4=Jiexiu Zhang |author5=Ninghong Song |author6=Zengjun Wang |author7=Changjun Yin |title=Transurethral seminal vesiculoscopy in the diagnosis and treatment of intractable seminal vesiculitis |date=February 2014 |journal=The Journal of International Medical Research |volume=42 |issue=1 |pages=236–42 |doi=10.1177/0300060513509472 |pmid=24391141|doi-access=free }}</ref> Intervention in the form of drainage through the skin or surgery may also be required if the infection becomes an [[abscess]].<ref name="Smiths2019" /> The seminal vesicles may also be affected by [[tuberculosis]], [[schistosomiasis]] and [[hydatid cyst|hydatid disease]].<ref name="smiths">{{cite book|last=El-Hakim|first=Assaad|title=Smith's Textbook of Endourology|date=13 November 2006|publisher=Wiley-Blackwell|isbn=978-1550093650|editor-last=Smith|editor-first=Arthur D.|edition=2nd|pages=759–766|chapter=Diagnosis and Treatment of Disorders of the Ejaculatory Ducts and Seminal Vesicles|chapter-url=https://books.google.com/books?id=Wo8cgdAsL-EC&pg=PA762}}</ref><ref name="causes">{{cite web|title=Seminal vesicle diseases|url=http://www.gfmer.ch/selected_images_v2/level2_disease.php?cat1=14|url-status=dead|archive-url=https://web.archive.org/web/20140426215602/http://www.gfmer.ch/selected_images_v2/level2_disease.php?cat1=14|archive-date=2014-04-26|publisher=Geneva Foundation for Medical Education and Research}}</ref> These diseases are investigated, diagnosed and treated according to the underlying disease.<ref name="Smiths2019" />

<!-- Cancer -->Benign tumours of the seminal vesicles are rare.<ref name="Smiths2019" /> When they do occur, they are usually papillary adenomata and cystadenomata. They do not cause elevation of [[Tumor marker|tumour markers]] and are usually diagnosed based on examination of tissue that has been removed after surgery.<ref name="Smiths2019" /> Primary [[adenocarcinoma]], although rare, constitutes the most common malignant tumour of the seminal vesicles;<ref name=":0" /> that said, malignant involvement of the vesicles is typically the result of local invasion from an extra-vesicular lesion.<ref name="Smiths2019" /> When adenocarcinoma occurs, it can cause blood in the urine, blood in the semen, painful urination, urinary retention, or even urinary obstruction.<ref name="Smiths2019" /> Adenocarcinomata are usually diagnosed after they are excised, based on tissue diagnosis.<ref name="Smiths2019" /> Some produce the tumour marker [[CA-125|Ca-125]], which can be used to monitor for reoccurence afterwards.<ref name="Smiths2019" /> Even rarer neoplasms include [[sarcoma]], [[squamous cell carcinoma]], [[Endodermal sinus tumor|yolk sac tumour]], neuroendocrine carcinoma, [[paraganglioma]], epithelial stromal tumours and [[lymphoma]].<ref name=":0">{{Cite journal|last1=Katafigiotis|first1=Ioannis|last2=Sfoungaristos|first2=Stavros|last3=Duvdevani|first3=Mordechai|last4=Mitsos|first4=Panagiotis|last5=Roumelioti|first5=Eleni|last6=Stravodimos|first6=Konstantinos|last7=Anastasiou|first7=Ioannis|last8=Constantinides|first8=Constantinos A.|date=31 March 2016|title=Primary adenocarcinoma of the seminal vesicles. A review of the literature|url=http://www.pagepressjournals.org/index.php/aiua/article/download/aiua.2016.1.47/5055|format=PDF|journal=Archivio Italiano di Urologia e Andrologia|volume=88|issue=1|pages=47–51|doi=10.4081/aiua.2016.1.47|issn=1124-3562|pmid=27072175|doi-access=free}}</ref>

=== Investigations ===
Symptoms due to diseases of the seminal vesicles may be vague and not able to be specifically attributable to the vesicles themselves; additionally, some conditions such as tumours or cysts may not cause any symptoms at all.<ref name="Smiths2019" /> When diseases is suspected, such as due to pain on ejaculation, [[Hematuria|blood in the urine]], [[infertility]], due to urinary tract obstruction, further investigations may be conducted.<ref name="Smiths2019" />

A [[Digital Rectal Examination|digital rectal examination]], which involves a finger inserted by a medical practitioner through the anus, may cause greater than usual tenderness of the prostate gland, or may reveal a large seminal vesicle.<ref name="Smiths2019" /> Palpation is dependent on the length of index finger as seminal vesicles are located above the prostate gland and retrovesical (behind the bladder).

A urine specimen may be collected, and is likely to demonstrate blood within the urine.<ref name="Smiths2019" /> Laboratory examination of seminal vesicle fluid requires a semen sample, e.g. for semen [[Microbiological culture|culture]] or [[semen analysis]]. [[Semen analysis#Fructose level|Fructose levels]] provide a measure of seminal vesicle function and, if absent, [[wikt:bilateral|bilateral]] [[agenesis]] or obstruction is suspected.<ref name="smiths" />

Imaging of the vesicles is provided by [[medical imaging]]; either by [[transrectal ultrasound]], [[Computed tomography of the abdomen and pelvis|CT]] or [[Magnetic resonance imaging|MRI]] scans.<ref name="Smiths2019" /> An examination using [[cystoscopy]], where a flexible tube is inserted in the urethra, may show disease of the vesicles because of changes in the normal appearance of the nearby bladder trigone, or prostatic urethra.<ref name="Smiths2019" />