Epididymitis associated with müllerian duct cyst and calculus: sonographic diagnosis.

Ardill, Richard; Manivel, J. Carlos; Beier-Hanratty, Sue A.; Ercole, Cesar J.; Letourneau, J G

doi:10.2214/ajr.155.1.2112873

Cited by 15 publications

(4 citation statements)

References 1 publication

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“…Prostatic utricular cysts are also located on the midline and sometimes communicate with the urethra and ED, but they tend to be confined within the prostate gland (Furuya and Kato, 2005; Torigian et al, 2007). ED cysts are rare, less common than Müllerian duct cysts and are usually the result of partial distal obstruction of the ED (Ardill et al, 1990). They usually occur in the paramedian location along the expected course of the ED.…”

Section: Discussionmentioning

confidence: 99%

Imaging Diagnosis, Transurethral Endoscopic Observation, and Management of 43 Cases of Persistent and Refractory Hematospermia

Liang

Sun

et al. 2012

Journal of Andrology

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The goal of this study was to explore minimally invasive transurethral imaging and surgery for the treatment of severe, persistent hematospermia in cases that were refractory to conservative treatments. The study included 43 patients (aged 22-77 years; average, 44.6 years) with long-lasting, severe hematospermia, accompanied by discomfort or pain in the lumbosacral or perineal region, dysuria, frequent micturition, decreased semen volume, and/or azoospermia. Patient symptoms had persisted for 1 to 10 years (average, 5.3 years). Computed tomography or magnetic resonance imaging of each patient was evaluated, and transurethral surgery was performed. The causes of hematospermia were identified in all 43 patients, and their ejaculatory duct obstruction or seminal vesiculitis was successfully treated. No serious intraoperative or postoperative complications occurred. Pathologic analyses revealed that all of the resected or biopsied seminal vesicle tissues had chronic nonspecific inflammation in the seminal vesicle wall, and no tumors were identified. Preoperative symptomology of hematospermia disappeared in all patients followed up for 2 to 30 months (average, 16 months). A single patient experienced recurrence at 11 months and had a second minimally invasive surgery that was curative. A total of 95.3% (41 of 43) of the patients experienced normal orgasmic intensity after surgery. Magnetic resonance imaging is a valuable and accurate diagnostic method for the identification of causative factors underlying hematospermia. Transurethral dilation of ejaculatory ducts, incision of the verumontanum or the distal end of the ejaculatory ducts, and incision or resection of the relevant cysts represent simple, safe, and reliable approaches for the management of refractory cases of hematospermia that do not respond to conservative treatments.

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Section: Discussionmentioning

confidence: 99%

Imaging Diagnosis, Transurethral Endoscopic Observation, and Management of 43 Cases of Persistent and Refractory Hematospermia

Liang

Sun

et al. 2012

Journal of Andrology

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“…Congenital or acquired cysts of ejaculatory ducts may lead to hematospermia (Worischeck and Parra, 1994). Usually ejaculatory duct cysts are the result of partial distal obstruction of the ejaculatory duct (Ardill et al, 1990). Simple cyst of the prostate parenchyma, also called prostatic retention cyst, is usually observed in the gland as an isolated lesion surrounded by normal tissue, and its TRUS features are an anechoic content with thin and smooth walls or hairline septa (Galosi et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

The Value of Transrectal Ultrasound in the Diagnosis of Hematospermia in a Large Cohort of Patients

Zhao

Luo

Wang

et al. 2012

Journal of Andrology

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Several studies have proved transrectal ultrasonography (TRUS) is efficient in the evaluation of patients with hematospermia, but the numbers of patients were less than 60 in each of the previous reports. Herein, a total of 270 patients with hematospermia were evaluated by TRUS to assess its efficacy in the etiologic diagnosis of hematospermia. The age of patients ranged from 15 to 75 years (x, 41.2 years), and the duration of symptoms was 1 day to 8 years (x, 3.4 months). Abnormalities were revealed by TRUS in 256 patients (94.8%). The percentages of pathological conditions located in the seminal vesicles, in the ejaculatory ducts, in the prostate, and in the bladder were 46.3% (125 cases), 29.6% (80 cases), 55.2% (149 cases), and 0.4% (1 case), respectively. The number of patients older than 40 years old and 40 years old or younger were 126 and 144, respectively. Our results show significantly higher percentages for malignant diseases, prostatic calcification and benign prostatic hyperplasia in the group of patients more than 40 years old compared with the group of patients 40 years old or less. Eight of 270 patients (3.0%) had malignant tumors, and all of the 8 malignancies occurred in patients more than 40 years old. TRUS is a noninvasive, reliable tool for the investigation of causes of hematospermia. Hematospermia is generally a benign symptom in younger patients. Special attention should be paid to elderly patients to exclude malignancy.

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“…Ejaculatory Duct Cysts.-Ejaculatory duct cysts are rare unilocular paramedian thin-walled cysts derived from the Wolffian (or mesonephric) duct system and occur as a result of partial distal obstruction of the ejaculatory duct, which can be congenital or acquired (18,19). Atresia or stenosis of the ejaculatory ducts are congenital causes whereas trauma, infection, or inflammation are acquired causes (20).…”

Section: Obstructive Causesmentioning

confidence: 99%

Hematospermia Evaluation at MR Imaging

Mittal¹,

Camacho²,

Sahani

et al. 2016

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Hematospermia is a challenging and anxiety-provoking condition that can manifest as a single episode or recur over the course of weeks to months. It is usually a benign self-limiting condition in younger sexually active males without a history of risk factors such as cancer, urogenital malformations, bleeding disorders, and their associated symptoms. However, patients with recurrent, refractory and painful hematospermia with associated symptoms, such as fever, pain, or weight loss, require evaluation through clinical assessment and noninvasive investigations to rule out underlying pathologic conditions such as ejaculatory obstruction, infectious and inflammatory causes, malignancy, vascular malformations, and systemic disorders that increase the risk of bleeding, especially when presenting in older men. If these investigations are negative, the patient should be reassured and treated accordingly. In the recent past, magnetic resonance (MR) imaging has assumed a major role in the investigation of hematospermia due to its excellent soft-tissue contrast and multiplanar capabilities. In this review, we will discuss the potential causes of hematospermia and its diagnostic workup, including pathophysiology, anatomic considerations, the imaging appearance of associated pathologic conditions, and management. (©)RSNA, 2016.

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Epididymitis associated with müllerian duct cyst and calculus: sonographic diagnosis.

Cited by 15 publications

References 1 publication

Imaging Diagnosis, Transurethral Endoscopic Observation, and Management of 43 Cases of Persistent and Refractory Hematospermia

Imaging Diagnosis, Transurethral Endoscopic Observation, and Management of 43 Cases of Persistent and Refractory Hematospermia

The Value of Transrectal Ultrasound in the Diagnosis of Hematospermia in a Large Cohort of Patients

Hematospermia Evaluation at MR Imaging

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