Chronic seminal vesiculosis

Novicki, Donald E.; Weber, Carl H.; Ball, Thomas P.; Gehring, G. Grant; Polsky, M. Sheldon; Jones, Al E.

doi:10.1016/0090-4295(76)90307-1

Cited by 1 publication

(1 citation statement)

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“…Disabling chronic perineal pain has also been described as an indication for combined prostatoseminal vesiculectomy [1]. Isolated transvesical vesiculectomy was used in an American airforce base in six patients with a symptom complex of persistent perineal, scrotal and lower back pain [2]. The overall incidence of urinary reflux into the seminal vesicles is unknown.…”

Section: Commentmentioning

confidence: 99%

Seminal vesiculectomy to resolve defecation‐induced orgasm

Schoot

Ypma

2002

BJU International

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A 70-year-old white man presented with a 10-year history of peculiar symptoms; after each defecation he had the sensation of ejaculation, although there was no penile discharge. Afterwards he noticed a rise in pulse rate and a sense of relaxation, which changed to fatigue. These symptoms resembled his sexual orgasm. Although pleasurable at first he was impaired with extreme fatigue in his daily life. By pressing on his perineum after defecation he was able to reduce his symptoms. He had no sexual or voiding complaints. When he voided urine with force he also felt the onset of the symptoms. He had previously consulted urologists and a neurologist, which had resulted in referrals to a psychiatrist and an acupuncturist. This produced no reduction in his symptoms. Six years before he had undergone retropubic prostatectomy for obstructive benign prostate disease. There was no history of recurrent epididymitis. During cystoscopy the orifice of the right ejaculatory duct in the colliculus of the prostatic urethra was unusually open and gaping; the left orifice was normal. A cystogram showed massive reflux into the right seminal vesicle (Fig. 1). A urethrogram showed no abnormalities. Subsequently he underwent transvesical bilateral vesiculectomy. The histological investigations were normal and his sexual function was unchanged after surgery; most importantly he had no more unusual symptoms after defecation. His fatigue resolved. CommentThe seminal vesicles are usually excised in combination with radical surgery for urological malignancies in the pelvis. Disabling chronic perineal pain has also been described as an indication for combined prostatoseminal vesiculectomy [1]. Isolated transvesical vesiculectomy was used in an American airforce base in six patients with a symptom complex of persistent perineal, scrotal and lower back pain [2]. The overall incidence of urinary reflux into the seminal vesicles is unknown. Urinary reflux and epididymitis has been described in infancy as a result of voiding dysfunction and a neurogenic bladder. Urinary reflux associated with UTIs and urinary dribbling has been described after transurethral resection [3]. The present patient noticed a relation between defecation and sexual symptoms. To our knowledge there is no relation between urinary reflux into the seminal vesicles and these symptoms. A possible hypothesis could be that the voiding of feces stimulated an ejaculatory response in a large dilated seminal vesicle caused by urinary reflux into the seminal vesicle. References

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Section: Commentmentioning

confidence: 99%