I. Etiology of seminal vesiculitis
Vesiculitis is caused by Escherichia coli, Klebsiella aerogenes, Proteus mirabilis and Pseudomonas aeruginosa. When there are infections in the organs adjacent to the seminal vesicles, such as the prostate, posterior urethra, and colon, or when any condition causes congestion in the prostate or seminal vesicles, the bacteria that cause the problem will take advantage of the opportunity to invade the seminal vesicles and induce seminal vesicle inflammation.
Clinically, seminal vesiculitis is divided into two categories.
(1) Acute vesiculitis systemic symptoms are pain around the body, chills and fever, even chills, high fever, nausea, vomiting, etc. Urinary symptoms are mainly burning sensation in the urethra, urinary frequency, urinary urgency, urinary pain and terminal hematuria with dripping urine and other symptoms of prostatitis, accompanied by severe pain in the perineum and rectum, the pain is aggravated when defecating, severe cases can affect sexual function and can cause severe pain during sexual intercourse. The total number and classification of white blood cells are elevated when routine blood tests are performed.
(2) Chronic vesiculitis is mostly caused by the evolution of acute vesiculitis lesions that are heavy or not thoroughly treated.
There are also some patients who have frequent sexual excitement or masturbation, causing congestion of the seminal vesicles prostate and secondary infection, leading to chronic vesiculitis. The symptoms of chronic vesiculitis and chronic prostatitis are not easily distinguishable and often exist at the same time. The blood in the semen (hematosperm) is a characteristic of chronic vesiculitis and is not easy to stop on its own, appearing at the time of ejaculation and continuing for several months.
What are the symptoms of vesiculitis?
This phenomenon is more obvious when the vesiculitis is in the acute stage.
2. Patients with vesiculitis may have symptoms such as frequent urination, urgent urination, painful urination, difficulty in urination, and burning sensation in the urethra.
3. Patients with vesiculitis may experience pain in the lower abdomen and vague pain in the suprapubic region. When vesiculitis is in the acute stage, the pain caused can also spread to the perineum and groin, and significantly intensify during ejaculation.
4. Patients with vesiculitis may experience systemic symptoms such as chills and fever. When the vesiculitis is in the chronic stage, the patient will also have low libido, seminal emission, premature ejaculation and other symptoms.
When a patient with vesiculitis undergoes a routine semen examination, it is seen that his semen contains a large number of red blood cells and white blood cells, and his semen is positive for bacterial culture; when a patient with vesiculitis undergoes a routine blood examination, it is seen that the number of white blood cells in his blood increases significantly.
The seminal vesicles are accessory glands of the male internal genitalia, they are located behind the bottom of the bladder and outside the abdomen of the vas deferens, and are a pair of oval-shaped vesicles that are wide at the top and narrow at the bottom, slightly flattened at the front and back, with an uneven surface, and a slightly larger bottom and straight lower mouth. Because the seminal vesicles have such structural characteristics, once they are infected, there will be poor drainage of inflammatory fluid. In addition, vesiculitis can affect the male reproductive system and can cause patients to develop complications such as prostatitis and infertility, so thorough treatment of vesiculitis is necessary.
It is important to note that vesiculitis is very closely related to prostatitis, and they are not only the same in terms of infection pathways, but also in terms of etiology, and the clinical manifestations are largely the same.
Why does hematosperm appear?
This is a serious case, the light case of blood sperm can not be detected by the naked eye, with the help of microscopic examination of the semen can be seen red cells, called “microscopic blood sperm.
Why does milky white semen become hematosperm?
The most common cause of blood sperm is vesiculitis, the seminal vesicles a storage sperm, two secretion of seminal fluid, the seminal vesicles have a rich microvascular layer, containing many microvessels, very easy to damage and bleeding, at the same time because the seminal vesicles are located above the prostate, between the bladder and rectum, its end and the vas deferens converge to form the ejaculate and lead to the urethra, because the seminal vesicles adjacent to the prostate, urinary tract, rectum and other organs, if these parts of the inflammation If these parts are inflamed, the bacteria will easily spread to the seminal vesicles causing inflammation, swelling, congestion and bleeding of the seminal vesicles, causing hematospermia, mostly accompanied by pain in the perineum, rectum and lower abdomen or painful urination.
Five, hematospermia must do the examination
1, physical examination and semen test of hematosperm
If a man encounters hematospermia, he should pay attention to the presence of other accompanying symptoms, such as the presence of urinary tract infection symptoms such as urinary frequency, urinary urgency, urinary pain; the presence of tuberculosis symptoms such as coughing up sputum, coughing up blood, low fever in the afternoon, night sweats; the tendency to bleed; the presence of urinary tract obstruction symptoms such as difficulty in urination; the presence of ejaculation pain and abnormal sexual function; the presence of lower abdominal pain, pain in the perineum and other parts of the body, and so on. Since certain antibacterial drugs applied in the treatment of cystitis can also discolor the semen, semen laboratory tests are necessary for patients with complaints of hematospermia.
2.Step-by-step ejaculation examination of hematospermia
For patients with hematospermia, some hospitals also require patients to do stepwise ejaculation examination, which can not only clarify the presence of red and white blood cells in semen, but also provide a preliminary estimate of the condition of the accessory gonads and the source of hematospermia.
3.Semen bacterial culture + drug sensitivity test
For some necessary patients, semen bacterial culture + drug sensitivity test is feasible, so that the doctor can choose the appropriate antibacterial drugs.
4.Imaging examination of hematosperm
The doctor may also ask the patient to do some imaging examinations, such as transrectal ultrasound examination is considered a preferred method to screen the prostate and seminal vesicles for stones, tumors, hypertrophy and other abnormal changes. For patients with abnormal findings on anal examination and ultrasound, especially the elderly, further examinations, including PSA, X-ray, CT, etc., are required to rule out prostate hypertrophy, prostate cancer, seminal vesicle cancer, germline tuberculosis and other diseases. For patients with combined hematuria, urethroscopy is feasible.
5.Other tests of hematospermia
In some patients with severe hematospermia, if white blood cells are found in the semen and it does not heal after repeated antibacterial treatment, the possibility of tuberculosis should be considered at this time, and tuberculin examination is feasible; for some difficult cases, the possibility of systemic diseases should be considered, and blood system diseases such as purpura, scurvy, leukemia and portal hypertension of liver cirrhosis should be excluded, and blood routine, coagulation function, liver and kidney function examinations can be performed.
6. Seminal vesiculitis and infertility
The vesicle gland is anatomically close to the prostate, vas deferens, urethra and bladder, and intercommunicates with each other, so vesiculitis is often secondary to infection of other organs of the urogenital system.
While vesiculitis alone is rare, chronic inflammation of the seminal vesicles can cause sterility and thus infertility. 90% of the seminal fluid is seminal vesicle secretions, of which fructose can be used by sperm as a power source; these secretions are reduced when the seminal vesicles are inflamed, which can affect the vitality of sperm; insufficient semen volume to fill the seminal pool in the posterior vaginal vault can also cause infertility.
How does vesiculitis affect fertility?
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This is the reason why there is no doubt that if the prostate gland and the vesicular gland are diseased, it will have a bearing on the fertility. The quality of seminal plasma components can be affected by vesiculitis and prostatitis in the following ways.
If the seminal vesicles and prostate gland become inflamed, the seminal plasma will be interspersed with bacteria, and lactic acid substances will also increase the force of the mouth bacterial toxins.
(2) The acidity is reduced, the normal seminal plasma acidity is 7.2-8.9 sperm in this environment to move freely. In the case of prostatic seminal glanditis, the acidity will increase and cause the sperm to abort.
(3) Increased viscosity, in the case of prostate vesiculitis seminal plasma that has bacteria, a large number of white blood cells, and even interspersed with pus. The viscosity will suddenly increase, when it is not easy to liquefy, sperm in the viability of the decline, which is related to the reduction of liquefaction enzyme.
(4) The number of abnormalities, in the seminal vesicle prostatitis, the secretion of seminal plasma is mostly reduced, which is not conducive to the survival of sperm, aseptic prostatitis, the amount of seminal plasma sometimes increases, so that the number of sperm in the unit volume is reduced, so that the dilution of sperm will also affect fertility.
How to prevent vesiculitis?
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The second is lymphatic infection, that is, inflammation of the genitourinary tract or intestinal tract, etc. through the lymphatic route to infect the seminal vesicles.
The third bloodstream infection, that is, other parts of the body, the pathogens of an infected lesion through the blood circulation to the seminal vesicles, because the seminal vesicles anatomically have many mucosal folds and twists, so secretions are easy to stagnate, resulting in poor drainage, if the acute inflammation is not completely controlled, it is easy to turn into chronic vesiculitis.