Is seminal vesiculitis a discrete disease entity? Clinical and microbiological study of seminal vesiculitis in patients with acute epididymitis

Purpose: To our knowledge direct evidence of inflammatory involvement of the seminal vesicles has not previously been reported in patients with acute epididymitis. We verified the discrete disease entity of seminal vesiculitis associated with acute epididymitis. Materials and Methods: The study included 13 patients who were clinically diagnosed with acute epididymitis. We report imaging, cytological and bacteriological findings in the seminal vesicles of patients with acute epididymitis. Results: On transrectal ultrasonography 12 of the 13 patients (92.3%) had dilatation of the seminal vesicle on the side ipsilateral to epididymitis. Dilatation of the contralateral side was found in only 4 patients. Seminal vesicle fluid from the ipsilateral side showed inflammatory findings in all patients. In patients 40 years and younger Chlamydia trachomatis was detected in seminal vesicle fluid in 7 of the 8 patients with epididymitis with results positive for the microorganism on first voided urine. Conclusions: Inflammatory responses were found in the seminal vesicles of patients with acute epididymitis. Chlamydia trachomatis was the causative pathogen most frequently detected in seminal vesicle fluid. Seminal vesiculitis is clearly associated with acute epididymitis and it may be a discrete disease entity.