Patient's question:
Patients with seminal vesicle cysts.Doctor's answer:
Problem Analysis: Hello, seminal vesicle cysts are mostly congenital, with a few caused by acquired factors. Congenital cysts can be accompanied by or without ureteral orifice ectopia and contralateral kidney agenesis or hypoplasia, as well as seminal vesicle dysplasia. Acquired cysts are mostly caused by inflammation or posttransurethral resection of the prostate (TURP) leading to obstruction of the ejaculatory duct, also known as retention cysts. These two types of cysts can be differentiated by their contents and location: congenital cysts are central and contain no sperm; retention cysts are mostly located laterally and contain sperm.Recommendations:
1. Transperineal or transrectal ultrasound-guided aspiration is suitable for smaller cysts with Ejaculatory duct obstruction or significant local symptoms. The disadvantage of this method is a high recurrence rate; an injection of sclerosing agent can be tried.
2. Transurethral cyst decapitation is suitable for acquired cysts or cysts near the prostate; the method involves local incision at the 5 and 7 o'clock positions of the transurethral prostate and distal to the bladder neck. The disadvantage is a high risk of retrograde ejaculation.
3. Open surgical treatment can be considered if the above methods fail. This includes cystectomy or partial cystectomy with drainage. If there are abnormalities such as ectopic ureteral orifices, they can be addressed simultaneously.