Patient's question:
Urgency and frequent urination are now occurring frequently... Moreover, it is accompanied by continuous lower abdominal pain. The vulva often feels uncomfortable. There is pain in the urethra during urination, accompanied by a burning sensation. During ejaculation, there is also blood-colored discharge, sometimes even blood clots, and ejaculation is very painful.Doctor's answer:
For the surgical treatment of seminal vesiculitis, the previously adopted measure of simple aspiration and injection of sclerosing agents to shrink the cyst has been unreliable, often leading to recurrence or infection, which complicates future surgeries. Therefore, surgical excision is now widely recommended. Due to the minimally invasive nature of the procedure, patients typically experience little pain. A small scrotal incision is sufficient to mobilize, dissect, and remove the cyst, with the surgical outcome often being excellent. During the surgery, the doctor will carefully separate the cyst from the testis and epididymis before completely excising it. The surgeon will take utmost care to avoid compressing or damaging the blood supply to the testis or disrupting the continuity between the epididymis and the vas deferens.If the cyst is open or has been aspirated preoperatively, the fluid may appear thin, white, or cloudy, and microscopic examination will reveal non-motile sperm. The complications associated with surgical excision of seminal vesiculitis are very minor and rare, including scrotal hematoma, infertility (if the epididymis is removed), or testicular atrophy if the blood supply to the testis is affected. Middle-aged and elderly patients who no longer require fertility can undergo low-dose local irradiation with X-rays, which can promote cyst shrinkage while causing minimal side effects.