Vesiculitis is an inflammation of the seminal vesicles. The seminal vesicles, due to intimate contact (blood, lymphatic, nervous) with neighboring organs, reflect the state of the latter. Inflammation of adjacent organs can lead to vesiculitis by directly involving the seminal vesicles in the process. Hematogenous and lymphogenous pathways of infection with vesiculitis are also not uncommon.
Of the predisposing moments of vesiculitis, it should be noted the frequent and prolonged hyperemia of the pelvic organs as a result of masturbation and abnormal sexual intercourse, the retention of secretion in the vesicles when the ejaculatory duct is compressed, and diseases of the colon. These moments themselves can be the cause of catarrhal inflammation of the seminal vesicles with vesiculitis.
In bacterial vesiculitis, gonococcal and tuberculous infections are most common, less often vesiculitis can be caused by staphylococcus, streptococcus, E. coli.
The study of the seminal vesicles with vesiculitis is carried out through the rectum in a standing position, forcing the patient to sit on the doctor's index finger, or in the lateral position of the patient with the lower limbs drawn to the stomach.
The clinical course of acute and chronic vesiculitis
According to the clinical course, vesiculitis can be divided into acute and chronic. Severity and pain in the rectal region with vesiculitis, aggravated by the act of urination and defecation to tenesmus, increased frequency of emissions, sometimes with purulent and bloody contents. There is general weakness, fever up to 39.9 and above. The diagnosis of vesiculitis in these cases is not particularly difficult.
Anamnesis, enlargement, tight tension of the seminal vesicle, pain with pressure on it - these are the most characteristic objective signs of an acute process. The secret obtained by massage is characterized by the presence of a large number of leukocytes, amorphous decay, epithelium, blood or hematoidin crystals, as well as the presence of deformed immotile spermatozoa.
Acute vesiculitis usually proceeds violently for 5-7 days and is resolved either by reverse development or transition to a chronic form or by the formation of empyema. In the latter cases, the abscess can burst into the urethra, which is the most favorable outcome, less often into the surrounding tissue, then into the ampulla of the colon, bladder, abdominal cavity.
Vesiculitis can be sluggish, chronic from the very beginning. In cases where an insignificant area of the mucous membrane is involved in the process, or after acute phenomena have passed, the process can go into a latent state and thus exist for many years. In the chronic stage, neuro-sexual symptoms come to the fore: frequent emissions, painful erections, increased sex drive, weak orgasm, sluggish and rapid ejection of semen, sometimes mixed with blood.
Treatment of the acute stage of vesiculitis should focus on enhancing the body's defenses through immunotherapy. In the treatment of chronic forms of vesiculitis, in addition to general treatment, a direct effect on the seminal vesicles is also necessary, which consists of systematic massage, warming them up by diathermy or hot microclysters, which usually gives good results.
In an unsatisfactory case, with catarrhal forms of vesiculitis, surgical treatment is indicated - vasotomy, vasopuncture with fibrous vesiculitis and empyema, vesiculotomy, and vesiculectomy are indicated.