Embryological and Diagnostic Aspects of Seminal Vesicle Cysts Associated with Upper Urinary Tract Malformation

Abstract

Congenital seminal vesicle cysts represent a rare but illustrative type of embryological malformation. They often are combined with ipsilateral upper urinary tract abnormalities. In most of the cases described in the literature the diagnosis has been made with rather invasive procedures. On the basis of our experience with 3 cases we recommend pelvic ultrasonography as the initial study in patients in whom such a malformation is suspected. Although other radiological procedures may be required to confirm the diagnosis, this approach appears to be cost-effective and accurate in most instances. The treatment of such malformations should be restricted to symptomatic cases and usually consists of vesiculectomy with or without removal of the ipsilateral dysplastic or hypoplastic kidney.

Diagnosis and Management of Seminal Vesicle Cysts Associated with Ipsilateral Renal Agenesis: A Pooled Analysis of 52 Cases

“…Seminal vesicle cysts are associated with ipsilateral renal agenesis in 68% [2]. Several case reports describe seminal vesicle cysts combined with ureteral ectopia in the seminal vesicle [4, 5, 6, 7, 8, 9, 10, 11, 12, 13], all kidneys with this anomaly were dysplastic [6]. Riba et al [10] described 36 cases of ectopia of the ureter to the seminal vesicle; only 4 of these were found during life.…”

“…We collected 42 case reports from the literature describing 51 males with seminal vesicle cysts and ipsilateral renal agenesis [1, 2, 3, 4, 5, 13, 14, 16, 17, 18, 19, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52]. One patient who presented in our clinic was included in the analysis: the total number of patients was 52.…”

“…Roehrborn et al [4] advocate the use of transabdominal ultrasonography as the first diagnostic procedure, because it is non-invasive, inexpensive and brings no radiation exposure. Weyman and McClennan [51] underline the excellent diagnostic properties of ultrasonography and CT scanning, whereas Schwartz et al [53] prefer CT scanning above ultrasonography because of the reduced chance of missing the diagnosis.…”

“…The aspiration was successful in 3 patients (30%) [29, 32, 34], however in 1 patient the aspiration (which was performed by the vas deferens) had to be repeated several times [32], and in another patient the procedure was complicated by epididymitis after aspiration, requiring antibiotic therapy [29]. In 3 patients the aspiration was done for diagnostic purposes and these patients underwent surgery afterwards [4, 35, 36]. Three patients suffered recurrence after initial aspiration and underwent surgery [19, 38, 45].…”

Laparoscopic Excision of a Congenital Seminal Vesicle Cyst and Coexisting Ipsilateral Renal Agenesis

“…These patients have frequently been misdiagnosed and thus treated with multiple courses of antibiotics without symptom resolution. 5 The diagnostic workup includes physical examination, transabdominal and/or transrectal ultrasonography, computed tomography, and/or magnetic resonance imaging. Additional studies include intravenous urography, retrograde cystourethrography, cystoscopic examination, and vesiculography.…”