What's in a name? Is an anatomical term only a name?

The purpose of a standard terminology is to facilitate communication. Thus, changing the name of an anatomical structure or the meaning of an anatomical term undermines that aspiration and cuts connections with anatomy's long history. Two types of anatomical terms are the most vulnerable to logical arguments for revision-ones that are descriptive, but viewed, at least by some, as inaccurate, and ones that contain words that are polysemic or vague. A half dozen examples of each type are discussed, including ductus deferens, glandula seminalis, articulationes costochondrales, vulva and fascia. In general, traditional terms should be preserved, but judgments about which terms are traditional should be based on five centuries of modern anatomy, not just the past several decades.

Non-monotonic effects of Bisphenol A Dimethacrylate on male mouse reproductive system and fertility leads to impaired conceptive performance

As an estrogenic agent, Bisphenol A Dimethacrylate (Bis-DMA) may incite alterations in both the reproductive tract and the neuroendocrine axis, and thus have the potential to affect the proper development, maturity and conceptive performance in animals. We investigated the consequences of 14 weeks of exposure to different concentrations of Bis-DMA on male mouse conceptive performance. Male mice were exposed to Bis-DMA (0, 0.1 mg/L, 1.0 mg/L or 10 mg/L) via drinking water, and the effects on fertility, reproductive organ weights, reproductive hormone levels, sperm counts and testicular histology were assessed. We clearly demonstrate that prolonged exposure of male mice to Bis-DMA negatively affects fertility and reproduction causing significant reductions in sperm counts, non-monotonic effects on serum LH and testosterone levels, increased seminal vesicle weights, lower number of embryonic implantations and viable fetuses, as well as, increased embryonal resorptions in females mated by Bis-DMA treated males. Furthermore, Bis-DMA caused abnormalities in testicular infrastructure with atrophic seminiferous tubules exhibiting intraepithelial vacuolization and disorganization, loss and shedding of germ cells into the lumen, and presence of apoptotic cells. Our data collectively suggest that Bis-DMA adversely affects male fertility and reproduction by interference with normal hormone signaling in the testis, inducing changes in testicular infrastructure and ultimately leading to impaired reproductive function and fertility.

Assessment of copper nanoparticles treatment on male accessory reproductive organs and epididymis in a mouse model: A morphological and biochemical study

Although the usage of nanoparticles has expanded substantially in recent years, and it causes the detrimental effect on the various organs. CuNPs are widely used in commercial applications. There has been minimal investigation into the possibly harmful effects of CuNPs on the accessory reproductive organs. Thus, the present study aimed to investigate the effect of CuNPs on the male reproductive organs like epididymis, vas deferens, seminal vesicle and prostate of mice. The mice were exposed orally to CuNPs at three doses 10, 100, and 200 mg/kg for 70 days. Our results showed that the organs index of only vas deferens and prostate reduced at 200 mg/kg group compared to the control. However, the histological study showed degenerative changes in the epididymis at higher doses like distortion in the tubules. The sperm parameters were also decreased in the 200 mg/kg CuNPs group. The vas deferens in 100 and 200 mg/kg treatment groups exhibited detachment of luminal epithelium and with a few or no spermatozoa in the higher dose group. The seminal vesicle and prostate also showed degenerative changes like atrophy, hyperplasia, and scant secretary materials. Furthermore, CuNPs also increased the oxidative stress and decreased antioxidant enzymes in vas deferens and seminal vesicles at higher dose. Caput epididymis showed decreased GPx enzymes in all the groups. However, MDA and GPx in corpus, cauda, and prostate did not show any significant variations among all the groups. In conclusion, our results suggest that CuNPs can manifest the detrimental effect of the male accessory organs and epididymis in a dose and tissue dependent manner. Since, detrimental effects were observed only at higher dose, thus, uses of CuNPs would be safe for reproductive organs at lower dose, even for the prolonged duration.

Zinner syndrome in pediatric patients: rare disease leading to challenging management

Introduction

Zinner syndrome (ZS) is the association of seminal vesicle cysts, ipsilateral ejaculatory duct obstruction, and ipsilateral renal agenesis. This condition is very rare in children and both diagnosis and treatment may be challenging. We reviewed the clinical presentation and treatment describing our experience with a series of three patients.

Methods

From January 2016 to January 2021, three patients (patients 1, 2, and 3) with symptomatic ZS, aged 2, 15, and 17 years, respectively, were diagnosed and treated. All three patients were symptomatic, manifesting pelvic pain and dysuria. The diagnosis was made by physical examination, ultrasonography, and abdominopelvic MRI. Patient 1 underwent open surgery, while for patients 2 and 3, laparoscopic excision was performed.

Results

The renal agenesis regarded the left side in patients 1 and 3, and the right side in patient 2. In all cases, the cystic complex was excised. The mean operating time was 4 h and the mean hospitalization time was 5 days (range 4-6 days). The mean follow-up period was 5 years (range 2-5 years). Patients 1 and 3 showed a complete resolution of the symptoms during postoperative follow-up. In patient 2, clinical symptoms relapsed because of the persistence of a 9 mm cyst requiring a redo laparoscopic excision.

Conclusions

Seminal vesicle cyst with ipsilateral renal agenesis, even if rare in pediatric age, should be suspected in young male patients presenting with pelvic cystic masses, pelvic pain, dysuria, and ipsilateral renal absence. Conservative management should be reversed to asymptomatic patients. Surgical treatment is mandatory in symptomatic cases and the preferred approach is minimally invasive surgery to magnify the operating field to spare anatomical structures, primarily the contralateral vas deferens. Radicality is crucial to avoid the persistence of symptoms and the need for reintervention.

Seminal Vesicle Stromal Lipofuscinosis: A Rare Incidental Finding with Potential for Misdiagnosis

We report a patient with isolated stromal lipofuscinosis of the seminal vesicle, a rare entity characterized by intracytoplasmic pigmented granules within stromal cells intimately surrounding seminal vesicle epithelium. Only 4 patients with this unusual phenomenon have been previously reported in the literature. Recognizing this incidental and presumably non-pathologic finding is important to prevent misclassification as a more concerning lesion.

Massive mixed epithelial-stromal tumour of seminal vesicle requiring challenging abdominoperineal resection: a case report and review of literature

Mixed epithelial-stromal tumours (MESTs) are a rare biphasic tumour that frequently arise in women from the renal and urogenital tract. They are also seen in men but are exceptionally uncommon with only few cases reported to originate from the seminal vesicles. Malignant transformation of its epithelial or stromal components is possible; however, by in large, these tumours are benign in nature. We report the case of a 48-year-old man with no remarkable medical or surgical history who presented with a huge expanding pelvic and intra-abdominal mass that required extensive surgical management including a pelvic exenteration. Histopathological analysis concluded the diagnosis of benign MEST originating from the seminal vesicles with no malignant features. No further systemic therapy was recommended for our patient. Given the technical intricacy in the operative resection of this tumour, we aim to present our findings and surgical management of this complex MEST.

Seminal Vesicle Treatment for Localized Prostate Cancer Treated with External Beam Radiotherapy

This study retrospectively reviewed data from men with localized prostate cancer treated with external beam radiotherapy (EBRT). We identified 359 men with localized prostate cancer treated with curative EBRT at the Cross Cancer Institute between 2010-2011. The volume of seminal vesicles (SVs) treated as well as dose values were extracted. These volumes were compared to gold standard contours drawn by a trained expert based on consensus European Society for Radiotherapy and Oncology (ESTRO) contouring guidelines. Patient and tumor characteristics were extracted for these patients. Memorial Sloan Kettering prostate cancer nomogram was used to assign a predicted risk of SV involvement for each patient based on baseline tumor characteristics. In patients with a predicted risk of SV involvement greater than 15% (n = 184), 86.5% (SD = 18.6) of the base of the SVs were treated with EBRT, compared to 66.7% (SD = 32.6) for patients with a predicted risk of SV involvement less than 15% (n = 175, p < 0.0001). Similarly, the mean percentage of proximal and total SV volumes treated with EBRT was 75.6% (SD = 24.4) and 68.7% (SD = 26.0) for patients with a predicted risk of SV involvement of greater than 15%, compared to 50.3% (SD = 31.0, p < 0.0001) and 41.0% (SD = 27.8, p < 0.0001) for patients with a risk of less than 15%. The results indicate that all parts of the SVs are more likely to be contoured in men with >15% risk of SV involvement than those with <15% risk. However, radiation oncologists still contour a high percentage of SVs in men with <15% risk of SV involvement, suggesting that there may be over-treatment of SVs that increases the risk of rectal or bladder toxicity.

Solitary fibrous tumor of the seminal vesicle

Solitary fibrous tumors (SFTs) are mesenchymal neoplasms with variable clinical behavior depending on age, tumor site, and size, and pathologic factors such as mitoses and necrosis. Imaging features on computed tomography (CT) or magnetic resonance imaging (MRI) are not specific, and the diagnosis relies on histopathology with immunohistochemistry. SFTs arising from seminal vesicles is rare and reported in only eight earlier cases. We discuss the clinical, histopathologic and positron emission tomography (PET) imaging characteristics of a 54-year-old patient with SFT of the seminal vesicle. The patient was treated with robot-assisted seminal vesiculotomy and is doing well on follow-up at two years.

The Male Reproductive System of the Kissing Bug, Rhodnius prolixus Stål, 1859 (Hemiptera: Reduviidae: Triatominae): Arrangements of the Muscles and the Myoactivity of the Selected Neuropeptides

The gross anatomy of the male reproductive structures and their associated musculature are described in the blood-gorging vector of Chagas disease, Rhodnius prolixus. The male reproductive system is composed of muscular tissues each performing contractions that aid in the movement of sperm out of the testis into the vas deferens, seminal vesicle and then into the ejaculatory duct, along with proteins and lipids from the transparent and opaque accessory glands. Phalloidin staining shows the various patterns of muscle fiber layers, from thin circular to more complex crisscross patterns, implying subtle differences in the form of the contractions and movement of each of the structures, allowing for waves of contractions or twisting patterns. The transcripts for the receptors for proctolin, myosuppressin (RhoprMS) and for the extended FMRFamides are expressed in the various regions of the reproductive system, and the nerve processes extending over the reproductive structures are positive for FMRFamide-like immunoreactivity, as are neurosecretory cells lying on the nerves. Proctolin and AKDNFIRFamide are strong stimulators for the frequency of the contractions, and RhoprMS can inhibit the proctolin-induced contractions. Taken together, this work implicates these two families of peptides in coordinating the male reproductive structures for the successful transfer of sperm and the associated accessory gland fluid to the female during copulation.

Functions of Steroid Hormones in the Male Reproductive Tract as Revealed by Mouse Models

Steroid hormones are capable of diffusing through cell membranes to bind with intracellular receptors to regulate numerous physiological processes. Three classes of steroid hormones, namely androgens, estrogens and glucocorticoids, contribute to the development of the reproductive system and the maintenance of fertility. During the past 30 years, mouse models have been produced in which the expression of genes encoding steroid hormone receptors has been enhanced, partially compromised or eliminated. These mouse models have revealed many of the physiological processes regulated by androgens, estrogens and to a more limited extent glucocorticoids in the testis and male accessory organs. In this review, advances provided by mouse models that have facilitated a better understanding of the molecular regulation of testis and reproductive tract processes by steroid hormones are discussed.

Acute Epididymo-Orchitis Complicated With Abscesses in Testis and Seminal Vesicles: A Case Report

Epididymo-orchitis is a common intra-scrotal inflammation among males that causes swelling of the epididymis and testis. In the era of modern antibiotics, complications associated with this condition are now rare. Herein, we report a 28-year-old man with acute epididymo-orchitis complicated by the formation of several abscesses involving the left testis and seminal vesicles. The literature review showed this patient as the first case with such extensive complications following epididymo-orchitis. Initial antimicrobial therapy was unable to resolve the condition. The management necessitated surgical intervention, which included MRI-guided aspiration of the seminal vesicle abscesses and testicular sparing drainage of the testicular abscess.

Schwannoma of Seminal Vesicle: A Case Report

Seminal vesicle neoplasms are extremely rare. Schwannoma is a benign tumor of the peripherical nerve sheath composed of Schwann cells. Most of these tumors are silent and become symptomatic with compression of adjacent organs and nerves. We present a case of a 72-year-old man who presented with a several months history of predominant storage lower urinary tract symptoms and painful ejaculation. Prostate-specific antigen (PSA) was within normal ranges, and imaging documented a retrovesical nodular lesion adjacent to the right seminal vesicle with 5 cm in width. We successfully performed a robotic-assisted laparoscopic surgery to excise the lesion. Anatomopathological analysis revealed a schwannoma.

Primary seminal vesicle epithelioid smooth muscle neoplasm of uncertain biologic potential

We present the case of a 73-year-old male patient who presented with obstructive urinary symptoms, pelvic pressure, and hematuria. CT imaging revealed a heterogenous prostate enlargement, and MRI demonstrated the mass to be arising from the seminal vesicle. Prostate biopsies showed benign tissue. Surgical excision was completed and pathology revealed it to be an epithelioid smooth muscle neoplasm of uncertain biologic potential. This is only the second known case of such a seminal vesicle tumour. As soft tissue sarcomas of the seminal vesicle emerge in the literature, we may develop a better understanding of their biologic behaviour and prognostic potential.

A Comparative Study on the Success Rates of Two Approaches for Seminal Vesiculoscopy

This study aimed to compare the success rates of two approaches for seminal vesiculoscopy: through the interior of the prostatic utricle and through the neck of the prostatic utricle. The patients were divided into two groups based on the seminal vesiculoscopy used. Group A was an interior of the prostatic utricle group (152 cases), and group B was a neck of the prostatic utricle group (146 cases). The general clinical data, intraoperative conditions and surgical results of the two groups were compared. Compared with group A, group B had a higher surgical success rate (94.5% vs. 62.5%, p < .001), a shorter operation time (33 min vs. 45 min, p < .001), less blood loss (0.5 ml vs. 2 ml, p < .001), a higher pain relief rate (86.6% vs. 52.3%, p < .001), a higher remission rate of haemospermia (82.2% vs. 58.5%, p = .011), a lower recurrence rate of pain (10.4% vs. 35.4%, p < .001), a lower recurrence rate of haemospermia (15.6% vs. 37.7%, p = .014), a higher symptom remission rate of the lower urinary tract (90.9% vs. 50.0%, p = .030), a higher remission rate of scrotal moisture (84.6% vs. 45.5%, p = .042) and a higher remission rate of frequent spermatorrhea (80.0% vs. 55.6%, p = .033). Seminal vesiculoscopy undertaken through the neck of the prostatic utricle has the characteristics of high success rate, short operation time and good surgical effect and is worthy of promotion and application.

Minimally invasive, 'en-bloc' seminal vesicle excision for locally advanced rectal adenocarcinoma: surgical technique and short-term outcomes

BACKGROUND

Isolated seminal vesicle invasion is a rare occurrence in patients with locally advanced rectal cancers. This study describes the surgical technique and the perioperative outcomes of minimally invasive 'en-bloc' seminal vesicle excision, preserving the bladder and the prostate.

METHODS

A retrospective review of 23 consecutive patients who underwent minimally invasive, en-bloc resection of seminal vesicles for locally advanced, non-metastatic rectal adenocarcinoma between May 2016 and November 2021. Perioperative outcomes and short-term oncological outcomes were defined.

RESULTS

Eighteen patients underwent a laparoscopic procedure while five received a robotic resection. All patients received preoperative radiation with or without consolidation chemotherapy. The median age was 42 years (range 20-64 years) and the median hospital stay was 8 days (range 3-19 days), respectively. Serious complications (Clavien-Dindo ≥ IIIb) were seen in six patients (26.1%). Two patients (8.7%) had an involved circumferential resection margin. At a median follow up of 19 months (range 2-52 months), four patients developed recurrences. The 2-year overall and disease-free survival was 84.4% and 73.6%, respectively.

CONCLUSION

Minimally invasive, en-bloc resection of one or both seminal vesicles for locally advanced rectal adenocarcinoma, is feasible in a select group of patients with acceptable morbidity and short-term outcomes.

Establishment of an animal model of ejaculatory duct obstruction

This study aimed to establish animal models with different degrees of ejaculatory duct obstruction. Forty-eight male rats aged 14-15 weeks were randomly divided into three groups (n = 16): control, complete ejaculatory duct obstruction (tied around the lower seminal vesicle gland and ductus deferens with a 2-0 silk ligature), and partial ejaculatory duct obstruction (padded with a wire guide). Mortality, complications, seminal vesicle morphology and histopathology were compared in the three groups at 4 and 8 weeks postoperatively. In the complete ejaculatory duct obstruction group, seminal vesicle weight decreased gradually with increased obstruction time compared with those of the control group (p < 0.05); moreover, stone-like material was occasionally observed. In the partial ejaculatory duct obstruction group, there was an increase followed by a decrease in seminal vesicle weight in the postoperative period compared with that of the control group (p < 0.05). Histopathological lesions of seminal vesicles were observed in the complete and partial ejaculatory duct obstruction groups (8 weeks postoperatively). We successfully established animal models of complete and partial ejaculatory duct obstruction, which provide an easy-to-use tool for studying seminal vesicle changes after ejaculatory duct obstruction.

PDGFRα (+) subepithelial interstitial cells act as a pacemaker to drive smooth muscle of the guinea pig seminal vesicle

KEY POINTS

In many visceral smooth muscle organs, spontaneous contractions are electrically driven by non-muscular pacemaker cells. In guinea pig seminal vesicles (SVs), as yet unidentified mucosal cells appear to drive neighbouring smooth muscle cells (SMCs). Two populations of spontaneously active cells are distributed in the SV mucosa. Basal epithelial cells (BECs) generate asynchronous, irregular spontaneous Ca²⁺ transients and spontaneous transient depolarisations (STDs). In contrast, subepithelial interstitial cells (SICs) develop synchronous Ca²⁺ oscillations and electrical slow waves. Pancytokeratin-immunoreactive (IR) BECs are located on the apical side of the basement membrane (BM), while platelet-derived growth factor receptor α (PDGFRα)-IR SICs are located on the basal side of the BM. Spontaneous Ca²⁺ transients in SICs are synchronised with those in SV SMCs. Dye-coupling between SICs and SMCs suggests that SICs act as pacemaker cells to drive the spontaneous contractions of SV smooth muscle.

ABSTRACT

Smooth muscle cells (SMCs) of the guinea pig seminal vesicle (SV) develop spontaneous phasic contractions, Ca²⁺ flashes and electrical slow waves in a mucosa dependent manner, thus it was envisaged that pacemaker cells reside in the mucosa. Here, we aimed to identify the pacemaker cells in SV mucosa using intracellular microelectrode and fluorescent Ca²⁺ imaging techniques. Morphological characteristics of the mucosal pacemaker cells were also investigated using focused ion beam/scanning electron microscopy tomography and fluorescent immunohistochemistry. Two populations of mucosal cells developed spontaneous Ca²⁺ transients and electrical activity, namely basal epithelial cells (BECs) and subepithelial interstitial cells (SICs). Pancytokeratin-immunoreactive BECs were located on the apical side of the basement membrane (BM) and generated asynchronous, irregular spontaneous Ca²⁺ transients and spontaneous transient depolarisations (STDs). The spontaneous Ca²⁺ transients and STDs were not diminished by 10 μM nifedipine but abolished by 10 μM cyclopiazonic acid (CPA). Platelet-derived growth factor receptor α (PDGFRα)-immunoreactive SICs were distributed just beneath the basal side of the BM and developed synchronous Ca²⁺ oscillations (SCOs) and electrical slow waves, which were suppressed by 3 μM nifedipine and abolished by 10 μM CPA. In SV mucosal preparations in which some smooth muscle bundles remained attached, SICs and residual SMCs developed temporally-correlated spontaneous Ca²⁺ transients. Neurobiotin injected into SICs spread to not only neighbouring SICs but also to neighbouring SMCs or vice versa. These results suggest that PDGFRα (+) SICs electrotonically drive the spontaneous contractions of SV smooth muscle. Abstract figure legend The seminal vesicles (SVs) of guinea pig generate spontaneous phasic contractions (SPCs). SV smooth muscle cells (SMCs, pink) develop SPCs associated with spontaneous electrical slow waves and Ca²⁺ flashes, which require the attachment of mucosal layer. Histological examination demonstrated the layer of PDGFRα-immunoreactive subepithelial interstitial cells (SICs, green) underneath of the basement membrane. The SICs spontaneously develop synchronous Ca²⁺ oscillations and the electrical slow waves, at the frequency corresponding to those of SPCs. The dye-coupling between SICs and SMCs further suggested that the synchronous electrical slow waves in the SICs electrotonically conduct to the SV SMCs via gap junctions (orange). Thus, the SICs appear to act as electrical pacemaker cells driving SPCs of SV. The basal epithelial cells (BECs, brown) also generated asynchronous, irregular spontaneous Ca²⁺ transients and spontaneous transient depolarisations, although their roles in developing SPCs remains to be explored. This article is protected by copyright. All rights reserved.

Primary angiosarcoma of the seminal vesicle

Angiosarcomas are rare but highly aggressive malignancies originating from lymphatic or vascular endothelial cells and may arise from any site in the body. Angiosarcomas of the genitourinary tract, especially of seminal vesicle origin, are extremely rare with only five reported cases. Surgery forms the mainstay of therapy in localised disease while adjuvant therapies are still being refined. We present the case of a 40-year old gentleman who presented with lower urinary tract symptoms and, on evaluation, was found to have a localised angiosarcoma originating in right seminal vesicle and offered laparoscopic resection, adjuvant paclitaxel (12 weekly cycles) and adjuvant radiation therapy (66 gray in 30 fractions). He developed a peritoneal nodular recurrence after 6 months of radiotherapy that was successfully salvaged with excision and metronomic chemotherapy, which he is currently receiving. Localised angiosarcomas need multimodality management despite small size. Attempts should be made for surgical salvage of limited recurrences whenever feasible.

Sperm Production Is Reduced after a Heatwave at the Pupal Stage in the Males of the Parasitoid Wasp Microplitisrufiventris Kok (Hymenoptera; Braconidae)

Simple Summary

Biocontrol with natural enemies of insect pests needs an optimal reproduction of beneficial insects. Most insects are sensitive to heat, and many males suffer from sperm decrease when exposed to warmth during their development. It is dramatic in hymenoptera because males are issued from the development of unfertilized oocytes and only females develop from fertilized eggs. The sex ratio of populations then results from the availability of sperm for egg laying females. Microplitisrufiventris is a parasite of the cotton worm; this moth is a major pest for cotton fields in Egypt. Because the temperature is high in Egypt, reproduction of M. rufiventris must be studied to optimize its use in the fields. We conducted experiments to measure the sperm number of males after heat periods during their development. It shows that M. rufiventris males have less sperm than controls when they were exposed to 36 °C and 40 °C short periods during their development. Moreover, those males live shorter than males that were maintained at 25 °C. In conclusion, we found, males to be sensitive to heat waves, which results in lower fertility, resulting in a lower availability of sperm for females leading to a sex ratio bias. It may lead to a decrease of the efficacy of biocontrol in cotton fields.

Abstract

Understanding reproduction is essential for controlling pests and supporting beneficial insects. Among the many factors allowing optimal reproduction, sperm availability is key to sex ratio control in hymenopteran parasitoids since males are haploid and only females come from fertilization. Microplitisrufiventris (Hymenoptera; Braconidae) is a solitary endoparasitoid of some noctuids. This insect could be used for the control of the cotton leafworm Spodopteralittoralis. Under controlled conditions, sperm quantity was measured in virgin males at 1, 5, 10, and 15 days; it increases in adult males until the fifth day. Sperm stock of control males increased from 2500 at one day to 6700 at 15 days. With the control climatic condition being 25 °C, we tested the effects of a time-limited increase of temperature that can be found in Egypt (36 and 40 °C) during one day at the early pupal stage. Emerging males had 1500 and 420 sperm at 36 and 40 °C, respectively; both lived shorter than the control. The sperm potential of males is dependent on both age and temperature during the early pupal stage. It could have dramatic consequences on the sex ratio of M. rufiventris in natural and controlled populations.

Male fertility in mice requires classical and nonclassical androgen signaling

Molecular mechanisms by which androgens signal through the androgen receptor (AR) to maintain male fertility are poorly understood. Transgenic mice were produced expressing mutant ARs that can only (1) alter gene transcription through the classical response pathway (AR-C) or (2) activate kinase signaling cascades via the nonclassical pathway (AR-NC). AR-C is sufficient to produce sperm and fertility. Haploid germ cell production, the blood-testis barrier, and spermatid migration are supported by AR-NC. Gene expression essential for chromosome synapsis during meiosis requires AR-C. We identify targets of androgen signaling required for male fertility and provide a mechanistic explanation for meiotic germ cell arrest in the absence of androgen signaling. Prostate differentiation occurs with AR-C alone, but full development requires synergistic nonclassical signaling. Both AR signaling pathways are necessary for normal male reproductive tract development and function, validating our mouse models for studies of AR functions in other target tissues.

Seminal vesicle leiomyosarcoma: Case report and literature review

INTRODUCTION AND BACKGROUND

Primary leiomyosarcoma of the seminal vesicle is an extremely rare and highly malignant disease with less than 15 cases reported.

CASE DESCRIPTION

A 34-year-old man presented with acute urinary symptoms. Imagen studies showed an abdominal mass (80 mm × 65 mm × 50 mm) with contrast enhancement, compressing the right side of the bladder but with a clear cleavage level between surrounding organs. The patient underwent a transrectal US-guided biopsy which was informed as compatible with leiomyosarcoma by immunohistochemical characterization. We performed a cystoprostatectomy and pelvic lymphadenectomy plus radiotherapy. Pathology showed a 7.5 cm × 6 cm nodular para-vesical Leiomyosarcoma histological grade 2 with 0/22 lymph nodes involved. Twelve months after the surgery no recurrences have presented.

CONCLUSION

A multi-disciplinary therapeutic approach, combined with close follow-up, is mandatory to obtain good outcomes in such rare and challenging cases.

Prognostic implication of staging of seminal vesicle invasion in patients with prostatic adenocarcinoma after prostatectomy

OBJECTIVES

To evaluate whether the extent of seminal vesicle invasion of prostatic adenocarcinoma can stratify the risk of biochemical recurrence after radical prostatectomy.

METHODS

We carried out radical prostatectomy for 1309 patients with prostatic adenocarcinoma between 2006 and 2019; 135 (10.3%) patients had seminal vesicle invasion. After excluding patients with neo-/adjuvant therapy, we reviewed 105 patients. We analyzed the correlation of the extent of seminal vesicle invasion and biochemical recurrence-free survival after prostatectomy and adjusted by various clinicopathological factors in multivariate analyses. Seminal vesicle invasion was stratified into three groups; the proximal part from the base was defined as level 1, followed by level 2 and the distal part as level 3.

RESULTS

Among the 105 patients, 30 (29%), 54 (51%) and 21 patients (20%) had seminal vesicle invasion at levels 1, 2 and 3, respectively. Median times to biochemical recurrence were 110, 67 and 12 months in patients with levels 1, 2 and 3, respectively (P = 0.002). The extent of seminal vesicle invasion was the independent risk factor for biochemical recurrence in univariate (level 3 vs 1, P = 0.001; level 3 vs 2, P = 0.015) and multivariate analyses (level 3 vs 1, P = 0.025; level 3 vs 2, P = 0.030).

CONCLUSIONS

The extent of seminal vesicle invasion might be a significant predictor of biochemical recurrence in prostate cancer patients undergoing radical prostatectomy.

Effects of Age, Phase Variation and Pheromones on Male Sperm Storage in the Desert Locust, Schistocerca gregaria

Simple Summary

We investigated male sperm storage in the desert locust Schistocerca gregaria. Phase (solitary or gregarious) did not affect sperm distribution in the vas deferens and seminal vesicle, whereas sperm accumulation of the seminal vesicle in gregarious locusts was promoted more than in solitary ones. Pheromones received from neither mature adults nor nymphs affected sperm distribution in the vas deferens and seminal vesicle. However, sperm accumulation in the seminal vesicle was more promoted in the gregarious locusts which received pheromones from mature adults than those obtained from nymphs at early adult stage, especially seven days after adult emergence.

Abstract

In general, sperm produced in the testis are moved into the seminal vesicle via the vas deferens in insects, where they are stored. How this sperm movement is controlled is less well understood in locusts or grasshoppers. In this study, the effects of age, phase variation and pheromones on male sperm storage were investigated in the desert locust, Schistocerca gregaria (Forskål). In this locust, a pair of ducts, the vasa deferentia, connect the testes to a pair of the long, slender seminal vesicles that are folded approximately thirty times, and where the sperm are stored. We found that phase variation affected the level of sperm storage in the seminal vesicle. Moreover, adult males that detected pheromones emitted by mature adult males showed enhanced sperm storage compared with males that received the pheromones emitted from nymphs: The former, adult male pheromones are known to promote sexual maturation of immature adults of both sexes, whereas the latter, nymphal pheromones delay sexual maturation. Most mature adult males had much sperm in the vasa deferentia at all times examined, suggesting daily sperm movement from the testes to the seminal vesicles via the vasa deferentia. As adult males aged, sperm were accumulated from the proximal part to the distal end of the seminal vesicle. Many sperm remained in the seminal vesicle after mating. These results suggest that young or new sperm located near the proximal part of the seminal vesicle could be used for mating, whereas old sperm not used for mating are stored in the distal part of the seminal vesicle.

Proteomic Dissection of the Impact of Environmental Exposures on Mouse Seminal Vesicle Function

Seminal vesicles are an integral part of the male reproductive accessory gland system. They produce a complex array of secretions containing bioactive constituents that support gamete function and promote reproductive success, with emerging evidence suggesting these secretions are influenced by our environment. Despite their significance, the biology of seminal vesicles remains poorly defined. Here, we complete the first proteomic assessment of mouse seminal vesicles and assess the impact of the reproductive toxicant acrylamide. Mice were administered acrylamide (25 mg/kg bw/day) or control daily for five consecutive days prior to collecting seminal vesicle tissue. A total of 5013 proteins were identified in the seminal vesicle proteome with bioinformatic analyses identifying cell proliferation, protein synthesis, cellular death, and survival pathways as prominent biological processes. Secreted proteins were among the most abundant, and several proteins are linked with seminal vesicle phenotypes. Analysis of the effect of acrylamide on the seminal vesicle proteome revealed 311 differentially regulated (FC ± 1.5, p ≤ 0.05, 205 up-regulated, 106 downregulated) proteins, orthogonally validated via immunoblotting and immunohistochemistry. Pathways that initiate protein synthesis to promote cellular survival were prominent among the dysregulated pathways, and rapamycin-insensitive companion of mTOR (RICTOR, p = 6.69E-07) was a top-ranked upstream driver. Oxidative stress was implicated as contributing to protein changes, with acrylamide causing an increase in 8-OHdG in seminal vesicle epithelial cells (fivefold increase, p = 0.016) and the surrounding smooth muscle layer (twofold increase, p = 0.043). Additionally, acrylamide treatment caused a reduction in seminal vesicle secretion weight (36% reduction, p = 0.009) and total protein content (25% reduction, p = 0.017). Together these findings support the interpretation that toxicant exposure influences male accessory gland physiology and highlights the need to consider the response of all male reproductive tract tissues when interpreting the impact of environmental stressors on male reproductive function.

Laparoscopic treatment of a giant seminal vesicle cyst with hemorrhage: A case report

RATIONALE

A seminal vesicle cyst is a benign lesion of the seminal vesicle that is usually asymptomatic. However, when a giant seminal vesicle cyst ruptures and bleeds, it can cause obvious clinical symptoms. To our knowledge, no single giant seminal vesicle cyst with hemorrhage has been reported in current studies, and surgery is the primary method to treat seminal vesicle hemorrhage with obvious symptoms.

PATIENT CONCERNS

A 31-year-old man presented with urination pain but without obvious urination frequency and urgency, dysuria, and discomfort. Rectal palpation in the chest-knee position revealed a hard mass palpable in the upper right with a smooth surface and mild tenderness, and the upper edge of the mass could not be palpated.

DIAGNOSIS

The results of the B-mode ultrasound indicated a mixed echogenic lump between the bladder and prostate, with a size of 81 × 76 mm. The computer tomography scan showed an "S" tubular lump in the right side of the pelvic cavity. The mass has a computer tomography value of 58 to 70 HU, and uneven reinforcement can be observed. On the basis of the results of the magnetic resonance imaging of the urinary bladder, the lump has T1 and T2 signals of equal lengths.

INTERVENTIONS

The patient was diagnosed with a huge right seminal vesicle cyst with hemorrhage and was treated via laparoscopic surgery.

OUTCOMES

The patient recovered quickly after the operation, and the symptoms of urination pain were significantly improved.

LESSONS

Seminal vesicle hemorrhage is clinically rare, and laparoscopic treatment is an effective and safe surgical method for the treatment of seminal vesicle cysts.

Rare case of immunoglobulin G4-related disease arising in gonadal glands with long-term remission without steroid treatment: Discussion and literature review

INTRODUCTION

Immunoglobulin G4-related disease embraces a wide range of extra-pancreatic manifestations. However, localized pathogenesis in gonadal glands, including testes or seminal vesicles, is rare. The clinical course and therapeutic strategy for this disease have not been clearly characterized.

CASE PRESENTATION

A 61-year-old Asian male had a left orchiectomy and right seminal vesicle biopsy because of a mass in the left testis and right seminal vesicle. Histological findings showed an infiltration of immunoglobulin G4-positive plasma cells in the respective tissues and met immunoglobulin G4-related disease diagnostic criteria. No recurrence and exacerbation have been observed after 12 years' follow-up without any clinical intervention. To date, immunoglobulin G4-related disease in gonadal tissue is rare. This is the first case with mass-forming lesions in both the testis and seminal vesicle.

CONCLUSION

Based on the clinical course of our case and the literature, for patients with accurately diagnosed inactive gonadal immunoglobulin G4-related disease, watchful waiting is a feasible clinical treatment option.

Anatomy and histology of reproductive system of adult male mint leaf beetle Chrysolina herbacea (Duftschmid, 1825) (Coleoptera: Chrysomelidae)

In this study, anatomy and histology of the male reproductive system of Chrysolina herbacea (Duftschmid 1825) (Coleoptera: Chrysomelidae) are described and illustrated by using light and scanning electron microscopies. Data from the male gonad of this species provide more extended and precise knowledge regarding the histoanatomical structure of the reproductive system in Chrysomelidae. The male reproductive system in C. herbacea consists of paired bilobed testes, two paired vas efferentia, paired seminal vesicles, paired vas deferentia, paired tubular accessory glands, a ductus ejaculatorius, and an aedeagus. Each testis consists of 40 follicles enveloped in a yellow pigmented sheath. In the light and scanning electron microscope examinations of male reproductive system of C. herbacea, different spermatogenesis stages (spermatocytes, spermatids, and spermatozoa) are found. Each testes follicle joins with the vas efferens surrounded by monolayered cubic epithelium with oval nuclei. Epithelial cells are covered from the outside with a thin layer of muscle and sheath. Vas efferens connect to vas deferens that may have an enlarged and differentiated region = seminal vesicle. Mature spermatozoa are seen in the lumen of the vas efferens, seminal vesicle, and vas deferens. There is a pair of accessory glands with a convoluted appearance in the tubular structure around the vas deferens. The vas deferens is a straight tube which leads into the proximal end of the ductus ejaculatorius. Ductus ejaculatorius wall is surrounded by intima, monolayer epithelium, and a thick muscle layer with many nuclei. The distal section of the ductus ejaculatorius is housed within the aedeagus.

Seminal Vesicle Schwannoma: Transrectal and Intraoperative Sonographic Findings

Schwannomas, namely neurilemmomas, are benign nerve sheath tumors and comprise the myelin sheaths around the peripheral nerves. Schwannomas commonly occur in the head and neck, or extremities, less found in the mediastinum and retroperitoneum, and rarely in the pelvis. We report a 40-year-old male presenting with an 18-month history of nocturia and urinary frequency. Transrectal ultrasound revealed a well-defined, 2.81 cm × 3.77 cm in size, homogeneous, hypoechoic mass in the tail of the left seminal vesicle, compatible with the finding of a well-demarcated mass at the left seminal vesicle with homogeneous contrast enhancement on computed tomography. He underwent laparoscopic excision of the mass via da Vinci robotic surgical system. Intraoperative sonography showed that the mass exhibited the majority of hypoechoic density with some hyperechoic spots inside. Pathology reveals schwannoma. Both of erectile and ejaculatory functions were claimed postoperatively. Our case report highlights the potential of either intraoperative or preoperative sonography in the assessment of the seminal vesicle schwannoma.

Three-dimensional reconstruction of the luminal structure of human seminal vesicle

The seminal vesicles are the glands of male reproductive organs that produce the fluid and nutrient constituents of semen. It has been believed for a long time that the lumen of a seminal vesicle was a single-coiled tubular structure with irregular diverticula. There are several previous reports on the symmetry, differences in morphological sizes and classification of the seminal vesicles. However, a three-dimensional-coiled tubular structure is difficult to understand using a classical anatomical methodology, and hence, three-dimensional reconstruction is needed to understand the structure of the lumen. Thirty-one seminal vesicles harvested from 21 formalin-embalmed cadavers were investigated. The seminal vesicle along with the ampulla of the ductus deferens was separated, and the length and width of each seminal vesicle were measured. The vesicles were then embedded in coloured paraffin, and the resulting paraffin block was sectioned transversely and photographed at an interval of 500 μm, with the sectioned surfaces then utilized in three-dimensional reconstruction performed by 'Reconstruct' software. The mean length and width of the seminal vesicles were 39.4 mm and 13.4 mm, respectively, and the right seminal vesicle was a little larger than the one on the left. The size differed from previous reports, while the luminal structure was similar to the classification of Aboul-azm (Archives of Andrology, 3, 1979, 287-292) but differed from that of Pereira (AJR. American Journal of Roentgenology, 69, 1953, 361-379). The seminal vesicles typically comprised about 9 curls and had about 12 diverticula. The seminal vesicles resembled a skein of coral rather than comprising a single strand. These findings will help in improving the understanding of pathophysiologies of the seminal vesicles, such as recurrent inflammation of the gland.

Pattern recognition receptor-mediated innate immune responses in seminal vesicle epithelial cell and their impacts on cellular function†

The seminal vesicles can be infected by microorganisms, thereby resulting in vesiculitis and impairment in male fertility. Innate immune responses in seminal vesicles cells to microbial infections, which facilitate vesiculitis, have yet to be investigated. The present study aims to elucidate pattern recognition receptor-mediated innate immune responses in seminal vesicles epithelial cells. Various pattern recognition receptors, including Toll-like receptor 3, Toll-like receptor 4, cytosolic ribonucleic acid, and deoxyribonucleic acid sensors, are abundantly expressed in seminal vesicles epithelial cells. These pattern recognition receptors can recognize their respective ligands, thus activating nuclear factor kappa B and interferon regulatory factor 3. The pattern recognition receptor signaling induces expression of pro-inflammatory cytokines, such as tumor necrosis factor alpha (Tnfa) and interleukin 6 (Il6), chemokines monocyte chemoattractant protein-1 (Mcp1) and C-X-C motif chemokine 10 (Cxcl10), and type 1 interferons Ifna and Ifnb. Moreover, pattern recognition receptor-mediated innate immune responses up-regulated the expression of microsomal prostaglandin E synthase and cyclooxygenase 2, but they down-regulated semenogelin-1 expression. These results provide novel insights into the mechanism underlying vesiculitis and its impact on the functions of the seminal vesicles.

Solitary recurrence of prostate cancer surrounded by seminal vesicle/vas deferens-like epithelium

INTRODUCTION

Clinical recurrence of prostate cancer after curative treatment with a limited number of metastases is often termed as oligorecurrence. We report a case of solitary recurrence of prostate cancer surrounded by epithelium of the seminal vesicle or vas deferens.

CASE PRESENTATION

A 54-year-old man diagnosed with localized prostate cancer underwent radiation therapy. Six years later, imaging studies detected a solitary recurrence. We performed metastasectomy, and histopathological examination revealed the metastatic lesion surrounded by the epithelium of the seminal vesicle or vas deferens. Surgical resection achieved a complete biochemical response.

CONCLUSION

We presented with a case of prostate cancer metastasis surrounded by the epithelium of the seminal vesicle or vas deferens.

Effect of chronic stress on expression and secretion of seminal vesicle proteins in adult rats

Chronic stress (CS) is known to affect men's health especially fertility by reducing semen quality. Although the effects of CS on testicular function and sperm parameters are documented, changes of substances and secreting proteins in the seminal vesicle (SV) have never been reported. This study aimed to demonstrate the alterations of contents and expressions of proteins in seminal vesicle fluid (SVF) under CS. Fourteen adult rats were divided into control and CS groups (n = 7/each). Control rats were not exposed to stressor, while the CS animals were immobilised by restraint cage (4 hr/day) and followed by forced swimming (15 min/day) for consecutive 60 days. Biochemical substances and malondialdehyde (MDA) level in SVF were examined. Expressions of heat-shock protein 70 (Hsp70), caspases (Casp) 3 and 9, and tyrosine-phosphorylated (TyrPho) proteins were investigated in seminal vesicle tissue (SVT) and SVF. It was found that CS caused reductions of seminal epithelial height and secreted substance levels. Significantly, MDA levels in SVF and expressions of Hsp70, Casp and TyrPho proteins were increased in of CS animals. It was concluded that CS affected seminal secretion. Low quality of CS seminal plasma may associate with increase of MDA and expressions of secreted proteins.

Multiple schwannoma of the seminal vesicle: A case report

RATIONALE

Schwannomas of the seminal vesicles are extremely rare, and only cases of single seminal vesicle schwannomas have been reported. Here, we report a case of multiple schwannoma of the seminal vesicle.

PATIENT CONCERNS

We report a rare case of multiple schwannoma of the seminal vesicle that occurred in a 48-year-old man during physical examination. Multiple mixed masses in the left region of the seminal vesicle were documented with transrectal ultrasonography and magnetic resonance imaging. The patient presented no clinical symptoms, no family history of the disease and no history of genetic disease.

DIAGNOSIS

Postoperative pathology revealed a diagnosis of seminal vesical schwannoma.

INTERVENTIONS

The patient underwent robotic-assisted laparoscopic surgery to remove the mass.

OUTCOMES

The patient recovered rapidly and the length of hospitalization was 6 days after operation. At present, there is no recurrence in 10 month follow up.

LESSONS

Whether benign or malignant, single or multiple, schwannomas still need to be diagnosed by pathology because of the limitations of examination methods. Surgical resection is still the preferred treatment.

Functional heterogeneity of PDGFRα (+) cells in spontaneously active urogenital tissues

AIMS

As PDGFRα (+) cells appear not to suppress the excitability of detrusor smooth muscle by generating SK3-dependent hyperpolarising as proposed in the gastrointestinal tract, we further explored the functional roles of PDGFRα (+) cells in regulating the spontaneous activity of urogenital tissues.

METHODS

Using PDGFRα-eGFP mice, intracellular Ca²⁺ signaling in PDGFRα (+) cells of the bladder lamina propria, renal pelvis, and seminal vesicle were visualized using Cal-590 fluorescence. The distribution and SK3 expression of PDGFRα (+) cells were also examined by immunohistochemistry.

RESULTS

In the bladder lamina propria, SK3 (-) PDGFRα (+) cells exhibited spontaneous Ca²⁺ transients and responded to stimulation of P2Y1 purinoceptors with MRS2365 (100 nM) or adenosine diphosphate (ADP) (100 μM) by developing Ca²⁺ transients. In the proximal renal pelvis, PDGFRα (+) cells were distributed in the mucosal, muscular and serosal layers but did not express SK3 immunoreactivity. PDGFRα (+) cells in the musculature resembling atypical smooth muscle cells generated spontaneous Ca²⁺ transients that were partially suppressed upon P2Y1-stimulation, while vigorously responding to human angiotensin II (100 nM). In the seminal vesicle, PDGFRα (+) cells in the musculature but not mucosa expressed SK3 immunoreactivity. In the mucosa, the P2Y1 stimulation evoked Ca²⁺ transients in both PDGFRα (+) cells and PDGFRα (-) cells.

CONCLUSION

PDGFRα (+) cells in spontaneously active urogenital tissues display heterogeneity in terms of their SK3 expression and P2Y1-induced Ca²⁺ responses. Muscular PDGFRα (+) cells in the renal pelvis and mucosal PDGFRα (+) cells in the seminal vesicle may generate depolarizing signals to drive smooth muscle cells.

Robot-assisted laparoscopic vesicule prostatectomy for mixed epithelial-stromal tumor of seminal vesicle

INTRODUCTION

Mixed epithelial-stromal tumor is a biphasic tumor with stromal and benign epithelial components. Only 40 cases of mixed epithelial-stromal tumor originating from a seminal vesicle have previously been published in English.

CASE PRESENTATION

A 52-year-old man was transferred to our hospital for evaluation of a 3.0-cm pelvic tumor detected incidentally by computed tomography. Robot-assisted laparoscopic vesicle prostatectomy was performed. We approached the Retzius space from both levels of the pouch of Douglas and peritoneal top of the bladder to clarify the tumor's environment. Pathologically, the tumor was diagnosed as a low-grade mixed epithelial-stromal tumor originating from the right seminal vesicle. There was no evidence of disease recurrence within 51 months.

CONCLUSION

This is the first report of robot-assisted laparoscopic vesicle prostatectomy for a seminal vesicle mixed epithelial-stromal tumor. Long-term observation is warranted due to the lack of reports with sufficient follow-up to ensure the procedure's safety.

Morphine and Phoenix dactylifera (dates) effects on the histological features of male rat reproductive organs

Background:

Previous studies have shown that morphine negatively effects male fertility while Phoenix dactylifera (dates) could cure male infertility by the exhibition of antagonist effects. This study was conducted to assess the possible ameliorating effects of dates on the histological features of morphine-induced male rat reproductive organs.

Materials and Methods:

Adult male Sprague Dawley rats age 7–9 weeks old, 200–250 g body weight (BW) were divided into six rats per each group: Group 1, force-fed with distilled water, 1 ml/kg BW for 35 days (control); Group 2, intramuscularly (IM) injected with morphine, 20 mg/kg BW for 7 days followed by force-fed with distilled water for 28 days; Group 3, force-fed with distilled water for 7 days followed by crude P. dactylifera extract, 200 mg/kg for 28 days; Group 4, injected (IM) with morphine, 20 mg/kg BW for 7 days followed by force-fed of crude P. dactylifera extract, 200 mg/kg for 28 days. Rats were sacrificed on day 36. The seminal vesicle (SV) and prostate gland (PG) were removed and fixed before histological processes.

Results:

In morphine-treated rats, the SV showed the absence of honeycomb-like appearance with flattened columnar cells while in the PG, eosinophilic secretion was noted to be absent from glandular lumina as compared to the control group. Administration of P. dactylifera extract in Group 4 showed improvement in histoarchitecture of the SV and PG with complex mucosal infoldings and glands luminal filled with secretion.

Conclusion:

P. dactylifera extract has a protective effect against the adverse effects of morphine on the male rat reproductive organs.

Management of Ejaculatory Duct Obstruction by Seminal Vesiculoscopy: Case Report and Literature Review

Ejaculatory duct obstruction is a rare condition identified in up to 5% of infertile men. Patients with ejaculatory duct obstruction can present with aspermia, azoospermia or oligoasthenospermia, painful ejaculation, hematospermia, prostatic pain, or male infertility. Semen analysis, transrectal ultrasonography, pelvic computerized tomography and magnetic resonance imaging are often used in the diagnostic work up, but with limited accuracy. While transurethral resection of the ejaculatory ducts has good efficacy for distal duct obstruction, results for proximal obstruction are less impressive, and it might cause severe complications, such as rectal injury and urinary incontinence. Recently, the use of high quality endourological devices and an improved understanding of ejaculatory ducts anatomy gleaned through the use of sophisticated imaging tools have led to the development of novel minimally invasive treatment options for this condition. The present study aims to report an index case of ejaculatory ducts obstruction managed with seminal vesiculoscopy, and review the current literature regarding this topic.

Seminal Vesicle Adherent to Rectal Wall Following Neoadjuvant Chemoradiotherapy: A Potential False-Positive Diagnostic Pitfall

The standard of care for stage T3 and stage T4 rectal adenocarcinomas involves neoadjuvant chemoradiotherapy followed by either low anterior resection or abdominopelvic resection. The presence of residual adenocarcinoma or positive surgical margins provides useful prognostic information and can influence ongoing adjuvant therapy. Although uncommon, mimics of treated adenocarcinoma may be present in the surgical specimen. A high index of suspicion is critical in avoiding potential false-positive pitfalls, and the exclusion of mimics of treated adenocarcinoma is paramount to accurate diagnosis and treatment. Seminal vesicle epithelium has long been a challenge in differentiating prostatic adenocarcinoma from benign epithelium. However, the role of incidental seminal vesiculectomy in rectal resections due to fibrous adhesion to the rectal wall secondary to chemoradiation has not been studied. As the seminal vesicle epithelium can show markedly atypical nuclei with radiation-type effect at baseline, the potential risk of misinterpretation as residual adenocarcinoma is high. In this article, we present 2 case reports of rectal adenocarcinoma treated with neoadjuvant chemoradiotherapy followed by transabdominal resection (low anterior resection or abdominopelvic resection) with incidental seminal vesiculectomies mimicking either residual adenocarcinoma or residual adenocarcinoma at a margin of resection.

Primary seminal vesicle adenocarcinoma: A case report of rare entity and discussion of its differential diagnosis using immunohistochemical approach for the core biopsy specimen

Primary seminal vesicle adenocarcinoma is a rare malignancy of the male genito-urinary system with only a few confirmed reported cases. Initial tissue diagnostic modality is often a core biopsy specimen. Here, we report this rare entity in a 50-year-old male, highlighting the histomorphological and immunohistochemical approach to the core biopsy specimen of the seminal vesicle mass. The patient presented with a history of haematospermia and gross haematuria for one year, and radiological workup was found to have a right seminal vesicle mass. A trans-rectal ultrasound guided core biopsy revealed a tumourous lesion with a predominant papillary architecture and cytological features of neoplasia. Based on positivity for CK7, PAX-8 and CA-125, and Ki-67 index of 30%-40% and negativity for PSA, AMACR, CK20, CDX-2, p63, GATA3, WT1 and calretinin, a diagnosis of primary seminal vesicle adenocarcinoma was offered. The diagnosis was also confirmed on the surgically resected specimen. This case depicts the approach of a pathologist to diagnose this rare entity on the core biopsy specimen and the possible differential diagnoses one must consider.

Zinner syndrome mimicking bladder outlet obstruction managed with aspiration

Zinner syndrome is a rare cystic malformation of seminal vesicle which consists a triad of unilateral renal agenesis, ipsilateral seminal vesicle cyst, and ejaculatory duct obstruction. The usual presentation is between the third and fourth decades of life, with infertility being the most common complaint. Ultrasound, cystoscopy, and magnetic resonance tomography (MRI) can easily detect this condition. Treatment option varies according to the presenting symptoms of the patient. We present a case of a 19-year-old male with recurrent episodes of urinary tract infection (UTI) and poor urinary stream. On ultrasound examination, the patient was found to have absent right kidney with a cystic swelling noted to be arising from prostate or seminal vesicle region which was further confirmed on MRI examination. Cystoscopy reveals a bulge on the right side of the verumontanum abutting the neck of the bladder. An ultrasound-guided aspiration of the cyst was performed which relieved the symptoms of the patient. Cystic abnormalities of the seminal vesicle are very uncommon. Symptomatic cases may present as recurrent UTI, infertility, bladder outlet obstruction, and painful ejaculation. Surveillance may be the option in the absence of clinical manifestations. Interventions such as image-guided aspiration or surgical procedures are appropriate when conservative measures prove ineffective.

Clinical outcomes of transperitoneal laparoscopic unroofing and fenestration under seminal vesiculoscopy for seminal vesicle cysts

Symptomatic seminal vesicle cysts (SVCs), especially those of a large size, can be removed by surgical treatments. Currently, open surgeries for SVC are rarely performed due to their extensive surgical trauma, and minimally invasive surgical therapies for treating seminal vesicle cysts are still in the early stages. In addition, relevant studies are mostly confined to case reports. In this study, we retrospectively reviewed 53 patients who had received transperitoneal laparoscopic unroofing or fenestration under seminal vesiculoscopy for SVC in our institution. Both surgeries decreased the cyst volume to a significant extent; however, according to the remnant lesion size after rechecking images, seminal vesiculoscopic fenestration tended to have a higher recurrence than laparoscopic unroofing. Regarding complications, two individuals in the laparoscopic unroofing group experienced ureteral injury and rectal injury, while patients in the fenestration group only had temporary hemospermia, which indicates that fenestration surgery tends to have less severe complications than laparoscopic unroofing. There was no solid evidence confirming semen improvement after these surgical therapies in our study. Future studies with a prospective design, larger sample size, and longer follow-up period are required to verify and further explore our findings.

The management and composition of symptomatic seminal vesicle calculi: aetiological analysis and current research

OBJECTIVE

To report our experience in the diagnosis, minimally invasive treatment, and composition of seminal vesicle calculi (SVC).

PATIENTS AND METHODS

In the present study, we evaluated 20 patients who were admitted to our hospital from January 2013 to January 2018. All the patients were diagnosed with intractable haematospermia and SVC. The diagnosis was further confirmed by seminal vesiculoscopy. SVC were removed by basket extraction; with larger SVC fragmented by holmium laser before extraction. Scanning electron microscopy, X-ray diffraction, and infrared spectroscopy were used to determine the SVC composition.

RESULTS

All operations were completed successfully without surgical complications. SVC were mostly composed of hydroxyapatite and protein, suggesting that they were produced by infections.

CONCLUSIONS

Seminal vesiculoscopy is a simple, minimally invasive technique that can be used for diagnostic confirmation and treatment of seminal vesiculitis with SVC. This study improves our understanding of SVC and provides a theoretical basis for the prevention of postoperative recurrence of SVC.

Comparison of preoperative locoregional Ga-68 PSMA-11 PET-CT and mp-MRI results with postoperative histopathology of prostate cancer

BACKGROUND

Conventional imaging modalities are inadequate to evaluate locoregional extension of prostate cancer (PCa). The aim of the current retrospective study was to investigate the diagnostic efficacy of Gallium-68 prostate-specific membrane antigen-11 (Ga-68 PSMA-11) positron emission tomography/computed tomography (PET/CT) and multiparametric magnetic resonance imaging (mp-MRI) for staging preoperative PCa patients with correlating histopathology.

MATERIALS AND METHODS

Twenty-four patients with histologically proven PCa underwent both Ga-68 PSMA-11 PET/CT and mp-MRI before robot-assisted laparoscopic radical prostatectomy. For each tumor area, correlations with histopathological results were defined for tumor localization, extraprostatic extension (EPE) of the tumor, invasion of seminal vesicle (SVI) and bladder neck invasion (BNI). In patients with regional lymph node (LN) dissection, histopathological results were also correlated with imaging modalities.

RESULTS

Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for detection of EPE and SVI were higher for mp-MRI than Ga-68 PSMA-11 PET/CT. On the other hand Ga-68 PSMA-11 PET/CT had significant successful results for detection of LN metastases when compared with mp-MRI. But for BNI detection both modalities had same insufficient results. Ga-68 PSMA-11 PET/CT had strong results for appropriate tumor localization in the gland.

CONCLUSION

Ga-68 PSMA PET/CT has superior results for assessing local LN metastases and for intraprostatic tumor localization. Whereas, mp-MRI must be the preferred modality for determining SVI and EPE. But both imaging modalities failed for determining BNI accurately. Both modalities should be used in conjunction with each other for better treatment planning.

Quantitative (stereological) study of the epididymis and seminal vesicle in the rat from young to old

There is a scarcity of morphometric data on the developmental and ageing changes in the epididymis and seminal vesicle in young and old rats. Eighty-six normal male Sprague-Dawley rats were randomly sampled from a cohort of animals aged 1-36 months (7-9 animals each age group). The epididymis and seminal vesicle (with the closely attached coagulating gland) were removed, and methacrylate resin-embedded sections were prepared for quantitative study of key histological structures by light microscopy. Stereological methods (point counting and optical disector) were used to estimate the total volumes of sperm mass, secretion (glandular lumen) and other structures and the number of spermatozoa. The results showed that the rapid growth of the reproductive organs was between 1 and 4 months of age. The epididymis stored the largest volume of sperm mass or number of spermatozoa at 12 months of age, but thereafter until 36 months of age, the sperm storage did not markedly diminish. The volume of secretion stored in the seminal vesicular gland declined by more than 35% from a plateau at 12-18 months until 36 months of age while that in the coagulating gland declined by more than 30% from a plateau at 18-24 months until 36 months of age.

Seminal vesicle metastasis after liver transplantation for hepatocellular carcinoma: A case report

RATIONALE

Cancer recurrence and metastasis after liver transplantation (LT) is common in some hepatocellular carcinoma (HCC) patients. The most common sites of extrahepatic metastases are lung, regional lymph node, adrenal gland, and bone. To our knowledge, HCC metastasis to the seminal vesicle after LT has not been reported in the literature.

PATIENT CONCERNS

A 56-year-old Asian man presented at hospital with a 9-year history of orthotopic LT because of HCC. The patient underwent surgery and radiotherapy for HCC metastasis to adrenal gland and 1 year later, chemotherapy for peritoneal metastasis. A few months later, the patient presented with computed tomography (CT) image showing masses in right lobe of liver, seminal vesicle, and space occupying mass between the spleen and stomach.

DIAGNOSES

Combination of clinical and pathological features revealed the seminal vesicle mass as metastasis from HCC.

INTERVENTIONS

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for liver and seminal vesicle lesions was performed and the postoperative pathology revealed malignancy. Thus, the patient underwent surgery and the diagnosis of seminal vesicle metastasis of HCC was confirmed by pathology and immunohistochemical analysis.

OUTCOMES

The patient died due to systemic failure.

LESSONS

Seminal vesicle metastasis from HCC after LT is rare and there is no consensus on its treatment. Further research into the pathogenesis and therapy of seminal vesicle from HCC after LT is needed to improve outcomes in the rare disease.

Zinner Syndrome in Pediatric Age: Issues in the Diagnosis and Treatment of a Rare Malformation Complex

Zinner syndrome (ZS) is the association of congenital seminal vesicle cysts and ipsilateral upper urinary tract anomalies, such as multicystic displastic kidney (MCDK). This condition is rare in pediatric age and both diagnosis and treatment are challenging. The aim of this study was to analyze the issues in diagnosis, management, and treatment of ZS in pediatric age. The medical records of two patients with ZS were examined. Furthermore, a review of the literature on this topic in pediatric age was performed. In our experience the diagnosis of ZS was incidentally achieved in the first months of life, as a consequence of studies performed for a prenatal diagnosis of MCDK. The first patient presented unspecific and transient symptoms, the second infant was completely asymptomatic. They were conservatively treated, with a long-term follow-up planned at least until adolescence. Fifty cases of ZS in pediatric age have been reported in the literature up to now. Only 12/50 were diagnosed in the first year of life. The diagnosis was demanding, as the clinical presentation was unspecific and the results at imaging studies needed a differential diagnosis with other retrovesical masses. More than 80% of these cases were asymptomatic at long-term follow-up. Therefore, a conservative management of ZS has been accepted for asymptomatic or poorly symptomatic patients, with occasional, transient, and unspecific symptoms, such as urinary tract infections or orchyepididimytis. As the surgical management is challenging, it is proposed only in those symptomatic patients. In conclusion, ZS is rare in pediatric age. However, it should be considered in the differential diagnosis of cystic masses within the pelvis in males with ipsilateral renal anomalies. A conservative treatment with a long-term follow-up is a safe option in the management of asymptomatic or poorly symptomatic patients, thus reserving the surgical approach only in those cases with symptoms.

[Finasteride inhibits microvascular density and VEGF expression in the seminal vesicle of rats]

OBJECTIVE

To investigate the effect of finasteride on the microvascular density (MVD) and the expression of the vascular endothelial growth factor (VEGF) in the seminal vesicle of rats.

METHODS

Forty male SD rats were randomly and equally divided into groups A, B, C and D, those in groups A and B fed with normal saline as the control and those in C and D with finasteride at 40 mg per kg of the body weight per day, A and C for 14 days and B and D for 28 days. Then the seminal vesicles of the animals were harvested for HE staining, measurement of MVD, determination of the expressions of CD34 and VEGF by immunohistochemistry, and observation of histomorphological changes in the seminal vesicle.

RESULTS

The expressions of CD34 in groups C and D were decreased by 6.7% and 15.8% as compared with those in A and B (P<0.01), and that in group D decreased by 9.3% in comparison with that in C (P<0.01). The expression indexes of VEGF in groups C and D were decreased by 6.9% and 14.1% as compared with those in A and B (P<0.01), and that in group D decreased by 9.0% in comparison with that in C (P<0.01).

CONCLUSIONS

Finasteride can inhibit the expression of VEGF in the seminal vesicle tissue of the rat and hence suppress the angiogenesis of microvessels of the seminal vesicle.

[Neurophysiological effects of seminal vesicles]

Seminal vesicles are involved in semen accumulation in the process of ejaculation, contracting and releasing seminal vesicle fluid accounting for about 50－80% of the semen, and the fructose in their secretions is an indispensable nutrient for sperm maturation. Thus, seminal vesicles are important male accessary glands closely related with the quality and quantity of sperm. In the process of semen accumulation, sympathetic and parasympathetic nerves participate in the regulation of the secretory function of seminal vesicle epithelia and the contraction of the smooth muscle layer as well as the distribution of adrenonergic, cholinergic, dopaminergic and various neurotransmitter receptors in the seminal vesicle epithelia and smooth muscle layer, which play a significant role in male fertility. This review discusses the neurophysiological effects of seminal vesicles in ejaculation.

Primary adenocarcinoma of the seminal vesicle

Primary adenocarcinoma of the seminal vesicle is a rare condition with only about 60 cases described in the literature. The unusual characteristics of this disease makes diagnosis difficult and treatment strategies differ as there are no specific guidelines available. This report presents a case of adenocarcinoma of the seminal vesicle with lung metastases in which surgical and chemotherapeutic treatments have been carried out. The MVAC dose dense regimen following local resection seems effective in this scenario and may be used in the treatment of this disease.