Seminal vesicle abscess

Seminal vesical abscesses are a complication of seminal vesiculitis.

Clinical presentation

The associated symptoms can be non-specific and are those typically associated with urinary tract infections:

• dysuria
• fever
• perineal or abdominal pain
• urinary retention
• ejaculation of purulent material

Pathology

Infectious agents such as Staphylococcus or E. coli have been associated with infection of the seminal vesicles.

Risk factors

• acute and chronic prostatitis (25%)
• urinary tract infection
• diabetes mellitus
• urological instrumentation
• urethral catheterization

Radiographic features

Ultrasound

• distended seminal vesicle with heterogeneous material inside

CT

• increase in volume and heterogeneous density of the seminal vesicle
• inflammatory changes of adjacent fat
• gas inside the vesicle may be seen
• peripheral enhancement on post-contrast images

MRI

Signal characteristics

• T1: iso-to-low signal
• T2: heterogeneous high signal
• DWI: high signal
• T1C+: peripheral enhancement

Treatment and prognosis

Antibiotics are the first line of treatment. Transperineal, transurethral or percutaneous drainage of the abscess is reserved for cases that do not respond to antibiotic therapy. Finally, surgical treatment is the last alternative for cases in which the other methods fail.