Seminal vesicle stones

Last revised by Dennis Odhiambo Agolah on 15 Nov 2022

Seminal vesicle stones or calculi refer to solid mineralized pieces of material within the seminal vesicles.

Seminal vesicle calculi are rare and have been mainly reported after the age of 40 years 1.

Seminal vesicle calculi are often associated with hematospermia.

The diagnosis of seminal vesicle stones can be conveniently made by typical imaging features on transrectal ultrasound (TRUS), CT or MRI 1,2. They might be also diagnosed on a pathological specimen.

Clinically seminal vesicle stones can present with hematospermia, hematuria, dysuria pelvic, perineal, testicular or ejaculatory pain and rarely spermolithiasis 1-4.

Seminal vesicle stones can consist of the following 3:

  • proteinaceous material

  • carbonate apatite

  • calcium oxalate

  • calcium fluorophosphate

The exact etiology of seminal vesicle stones seems to be unclear,  possible etiological factors include the following 1,2:

Seminal vesicle stones are visible on different imaging methods including transrectal ultrasound (TRUS), CT and MRI as well-defined, intraluminal structures within the seminal vesicles 1,2. They might be calcified or non-calcified.

On transrectal ultrasound (TRUS) seminal vesicle stones have been described as well-circumscribed hyperechoic foci with or without acoustic shadowing that can be distinguished from the typical architecture of the seminal vesicles 1.

Computed tomography is able to depict seminal vesicle calculi within the seminal vesicle lumen in different planes and is especially useful if they are calcified.

On prostate or pelvic MRI, seminal vesicle stones can be visualized as polygonal intraluminal structures surrounded by seminal fluid or associated with hematospermia 2,4.

  • T2: hypointense

  • DWI: lack of diffusion restriction

  • DCE (Gd): no enhancement

The radiological report should include a description of the following:

  • location form and extent of intraluminal stones

  • seminal vesicle hemorrhage

  • associated findings and etiologies e.g. ejaculatory duct obstruction or prostate cancer

Management of seminal vesicle calculi includes surgical intervention for stone removal. Different surgical approaches include transurethral resection of ejaculatory ducts (TURED), transurethral seminal vesiculoscopy (TRU-SVS) endoscope laser lithotripsy, laparoscopic, robot-assisted and open approaches 1,2,4.

The first case report of seminal vesicle stones was made by White in 1928 1.

Conditions that may be mimicking the clinical presentation or imaging appearance of  seminal vesicle calculi include 1:

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Cases and figures

  • Case 1
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  • Case 2
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