Imaging findings of congenital anomalies of seminal vesicles

Abstract

The seminal vesicles are paired organs of the male reproductive tract, which produce and secrete seminal fluid. Although congenital anomalies of seminal vesicles are usually asymptomatic, they may lead to various urogenital symptoms, including infertility. Due to their embryologic relationship with other urogenital organs, congenital anomalies of seminal vesicles may accompany other urinary or genital anomalies. Congenital anomalies of seminal vesicles include agenesis, hypoplasia, duplication, fusion, and cyst. These anomalies can be diagnosed with various imaging techniques. The main purpose of this article is to summarise imaging findings and clinical importance of congenital anomalies of seminal vesicles with images of some rare and previously unreported anomalies.

Keywords: computed tomography (CT); congenital anomalies; magnetic resonance imaging; seminal vesicles; ultrasound (US).

Figure 1

32-year-old male with nephrolithiasis. Axial computed tomography image of the abdomen shows no seminal vesicle posterior to the prostate on the left

Figure 2

33-year-old male with left flank pain. A) Axial and (B) coronal computed tomography of the abdomen reveals seminal vesicle agenesis in the right and ipsilateral renal agenesis

Figure 3

35-year-old male with urolithiasis. Axial computed tomography of the pelvis shows agenesis of right seminal vesicle, ectopic opening of the right ureter into bladder superolaterally than normal, and stones in the right ureter and bladder

Figure 4

72-year-old male with increased alkaline phosphatase levels. Axial contrast-enhanced computed tomography images shows seminal vesicle hypoplasia on the right (arrow)

Figure 5

62-year-old male with elevated prostate specific antigen (PSA) levels. A) Axial T1 and (B) T2 images show cystic dilatation of the left seminal vesicle. C) Coronal T2 images show ectopic opening of the dilated ureter into the seminal vesicle cyst. D) Axial subtracted magnetic resonance image shows no enhancement of the cyst except the walls

Figure 6

26-year-old male with intermittent perineal pain. A) Axial T1 and (B) fat-sat T2 images show hyperintense multi-lobulated right seminal vesicle cyst and left seminal vesicle agenesis. C) Coronal fat-sat T2 image shows right kidney agenesis and hypertrophied left kidney. Right seminal vesicle cyst can also be seen (arrow)

Figure 7

31-year-old male patient with left orchiectomy secondary to testicular tumour. A) Contrast-enhanced computed tomography scan of abdomen shows left dysplastic kidney and left paraaortic metastatic lymphadenopathy. B) No seminal vesicle is seen on the right. A soft tissue density extending to the left side of bladder, is continuous with left seminal vesicle. C) Axial T2-weighted magnetic resonance imaging of the abdomen: No seminal vesicle is seen on the right (arrowhead). Dilated cystic structure (black arrow) is continuous with the stump of the left vas deferens (white arrow)

Figure 8

51-year-old male with perforated cholecystitis. A) Axial contrast enhanced fat-sat T1 image shows right seminal vesicle cyst. B) Oblique coronal computed tomography image reveals calcified dysplastic right kidney with dilated ureter, which drains into the right seminal vesicle cyst, and increased density in mesenteric fat due to cholecystitis (not shown)

Figure 9

34-year-old male with intermittent pelvic pain and history of left seminal vesicle cyst aspiration 2 years ago. A) Coronal-contrast enhanced computed tomography (CT) image shows left renal agenesis, and (B) axial CT image shows left seminal vesicle cyst displacing bladder anteriorly