The Seminal Vesicles: Normal and Pathological Pictures
The morphology of seminal vesicles is precisely evaluable with transrectal approach, especially with end-fire probe and with oblique scan. Standard criteria, divided into conventional and unconventional, are used to evaluate the modifications of ultrasoun
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Carmen Maccagnano, Andrea Benedetto Galosi, and Vincenzo Scattoni
25.1 Introduction The seminal vesicles (SVs) are part of the male reproductive system. They are located proximally to the posterior aspect of the prostate; they secrete a viscous fluid which constitutes the 70 % of the ejaculate [1, 2]. These two SVs are tubular structures which, if stretched, show a length of about 15 cm. In the fold, orthotopic conformation, the length is about 5–7 cm and the diameter is about 2–3 cm. The capacity range is 3–6 ml. Their shape is cone-like and they join to the deferential ampoules through their apex, originating the ejaculatory duct. The ejaculatory duct is 2 cm long and the lumen is 1 mm width. The ejaculatory duct joins the urethra with orifice located on the veru montanum. The SVs are located between the posterior wall of the bladder neck and the prostate, and they join C. Maccagnano Department of Surgery, Division of Urology, Azienda Ospedaliera S.Anna –Como, Via Ravona, 20, San Fermo della Battaglia (Co), Italy e-mail: [email protected] A.B. Galosi (*) Institute of Urology, Marche Polytechnic University, Ancona, Italy e-mail: [email protected] V. Scattoni Department of Urology, Scientific Institute H San Raffaele, University Vita-Salute, Via Olgettina 60, Milan 20132, Italy
the ampoules of the deferens duct, situated above the prostate. They are posteriorly related with the rectal anterior wall. The peritoneum covers only the posterior aspect of the SV bottom. The SVs are palpable during digital rectal examination, because of their close relation with the rectum. The two SVs, which connect each other with dense fibrous tissue, are laterally related to the venous periprostatic plexus. Every SV is made up of a duct with irregular diameter, provided with several ampullar or tubular diverticula, of variable length. One extremity of the duct shows a blind end, whereas the other is linked to the deferential ampulla. The curvy coils and diverticula are placed one against the other, with the interposition of connective sepimenta which thicken on the surface of SV, forming the adventitial tonaca. The wall of SV is made of three layers: mucosal, muscularis, and adventitial. The mucosal layer is represented by covering simple cylindrical epithelium, with interposed basal cells, and by the lamina propria. The cylindrical cells, defined as principle or secretory, contain the secretory vesicles which are more represented in the apex, where they open on the cell surface and transfer their fluid into the lumen. The basal cells are deeply located among the cylindrical cells. The role of the basal cells is substituting and/or sustaining the main cylindrical cells. The thin lamina propria contains several elastic fibers and some isolated fibrous muscular cells.
© Springer International Publishing Switzerland 2017 P. Martino, A.B. Galosi (eds.), Atlas of Ultrasonography in Urology, Andrology, and Nephrology, DOI 10.1007/978-3-319-40782-1_25
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The mildly thick muscular layer contains small bundles made of
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