Hematospermia secondary to seminal vesicle duct calculi

Case contributed by Dr Vinayak Vishwanath Kabate

Presentation

Chronic recurrent blood in the semen.

Patient Data

Age: 40 years
Gender: Male

MRI of pelvis shows mildly bulky bilateral seminal vesicles showing T1 slightly hyperintense signal with slight T2 shading, indicating hemorrhagic contents within the seminal vesicles. 

There are small two right and single left T2 and T1 hypointense structures in the excretory ducts of bilateral seminal vesicles- representing excretory duct calculi.

Prostate gland shows normal features. 

Selected imaged demonstrate T1/T2 hypointense foci consistent with calculi within the seminal duct. 

Case Discussion

This case illustrates MRI features of hematospermia and its cause,  small calculi in excretory ducts of bilateral seminal vesicles.

Hematospermia in middle-aged males needs the evaluation of pelvic organs to rule out various causes, including ejaculatory obstruction, infectious/inflammatory causes, malignancy, vascular malformations and systemic disorders with increased risk of bleeding. 

Obstruction of excretory ducts of seminal vesicles or the ejaculatory ducts due to calculi or other causes can be made out on MRI with an occasional need of complementary CT sections. 

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Case information

rID: 59411
Published: 19th May 2018
Last edited: 14th Aug 2019
System: Urogenital
Inclusion in quiz mode: Included