Clinical Correlations between Transrectal Ultrasonographic Findings of the Seminal Vesicles and Ejaculatory Ducts, and Symptoms

Song, Myeong Heub; Chang, Hyun Seok; Shin, Dong Shin; Choo, Myung Soo; Choi, Nak Gyeu

Abstract

Transrectal ultrasonography provides an accurate assessment of the prostate, ejaculatory ducts and seminal vesicles, which can be helpful in the evaluation of the patients with variable genitourinary symptoms. We studied 65 symptomatic patients and 20 age-matched controls who underwent transrectal ultrasonography from Feb. 1993 to Jul. 1993. The broad spectrum of genitourinary signs and symptoms was segregated into 4 groups. Group 1 was hematospermia. Group 2 was pains including ejaculatory pain, pain on erection. perineal pain, scrotal pain, tenderness on prostate grand, suprapubic pain, lower back pain, inguinal pain, and penile pain. Group 3 was bladder outlet obstructive symptoms including hesitancy, intermittancy, terminal dribbling, weak stream, and residual urine sensation. Group 4 was bladder irritative symptoms including frequency, nocturia, urgency, and dysuria. The major abnormal findings on the transrectal ultrasonography were cysts in seminal vesicle, cysts in ejaculatory duct, prostatic calculi, ejaculatory duct calculi, and seminal vesicle dilation. Compared with age-matched controls, symptomatic patients had significantly increased prevalence of the abnormal findings on the transrectal ultrasonography (p <0.01 ). Ejaculatory duct calculi were significantly associated with bladder outlet obstructive symptoms and bladder irritative symptoms (p <0.05), and seminal vesicle dilation was also significantly associated with pain (p <0.05). Prostatic calculi and ejaculatory duct calculi were closely associated with voiding dysfunction, however, cyst in seminal vesicle and ejaculatory duct were closely associated with pain. Transrectal ultrasonography offers clinical insights into the causes of distressing genitourinary symptoms, and may be helpful in their management.