Vas deferens sonographic appearances of tuberculosis lesions of 19 cases of male genital systemic tuberculosis

Abstract

To investigate the sonographic findings of the vas deferens in male genital tuberculosis.The ultrasonographic findings of the vas deferens of 19 cases of genital tuberculosis were retrospectively analyzed.According to the pathological and ultrasound findings, the ultrasonographic appearances of the vas deferens tuberculosis could be divided into 4 groups, 1 of normal sonograms, 3 of abnormal sonograms. The abnormal ultrasonographic appearances of the vas deferens tuberculosis were considered 3 categories as follows: diffusely thickening of vas deferens, nodular thickening of vas deferens, and space-occupying lesions adjacent to the vas deferens.The ultrasound manifestations of vas deferens in tuberculosis of the male genital system have certain characteristics. Combination of clinical manifestations, history of tuberculosis, experimental antituberculosis treatment, and ultrasound examination of vas deferens can suggest tuberculosis of vas deferens. Furthermore, it can provide objective basis for the comprehensive and noninvasive evaluation of the impact of genital tuberculosis on the reproductive ability for further treatments.

The Role of Contrast-Enhanced Ultrasound in the Differential Diagnosis of Tuberous Vas Deferens Tuberculosis and Metastatic Inguinal Lymph Nodes

“…Simultaneously, caseous substances block the VD lumen and form local nodules. Tuberculous VD mainly shows hypoechoic and mixed echogenicity signals, and rarely presents strong echogenicity [2]. Because a tuberculous pattern with strong echogenicity is usually observed in the later disease stage, it can be easily distinguished from the metastatic lymph nodes on the basis of internal echogenicity; therefore, patients with these patterns were not included in this study.…”

“…Here, the vas deferens on both sides gradually approach and expand into the ampulla of the vas deferens. So the vas deferens are anatomically divided into the pelvic VD, groin VD, spermatic VD, and testes VD [2].…”

“…VD TB is one of the causes of male infertility [3,4]. According to US manifestation, VD TB can be divided into three types: uniformly thickened wall type, tuberous type, and abscess type [2]. Genital tuberculosis is uncommon [5], and the incidence of tuberous VD TB is also very low, which leads to the lack of understanding of imaging physicians and often leads to misdiagnosis.…”

Why do we miss isolated male genital tuberculosis diagnosis?

“…Nevertheless, since this term is commonly used in the literature, we will also use it here. Male genital TB was classified by Kulchavenya as follows [6]: -Orchiepididymitis (unilateral or bilateral); -TB of the penis (TBP); -Prostate TB; -TB of seminal vesicles; -The vas deferens and Cowper's glands involvement may also occur [7]. Complications of MGTB include strictures, fistula, infertility and sexual dysfunction [6].…”

Application of contrast-enhanced ultrasound in the diagnosis of tuberous vas deferens tuberculosis

“…In the course of disease progression, the tuberculosis bacterium further proliferates in the VD wall, which thickens and is further destroyed. Simultaneously, the caseous material blocks the VD lumen, forms local nodules, breaks through the VD wall, and then forms peripheral cold abscesses [ 1 ]. Tuberous VD TB is a TB tubercle of the vas deferens that is formed by TB invading the VD.…”