Clinical Correlations between Transrectal Ultrasonographic Findings of the Seminal Vesicles and Ejaculatory Ducts, and Symptoms / 대한비뇨기과학회지

Transrectal ultrasonography provides an accurate assessment of the prostate, ejaculatory ducts and seminal vesicles, which can be helpful in the evaluation of the patients with variable genitourinary symptoms. We studied 65 symptomatic patients and 20 age-matched controls who underwent transrectal ultrasonography from Feb. 1993 to Jul. 1993. The broad spectrum of genitourinary signs and symptoms was segregated into 4 groups. Group 1 was hematospermia. Group 2 was pains including ejaculatory pain, pain on erection. perineal pain, scrotal pain, tenderness on prostate grand, suprapubic pain, lower back pain, inguinal pain, and penile pain. Group 3 was bladder outlet obstructive symptoms including hesitancy, intermittancy, terminal dribbling, weak stream, and residual urine sensation. Group 4 was bladder irritative symptoms including frequency, nocturia, urgency, and dysuria. The major abnormal findings on the transrectal ultrasonography were cysts in seminal vesicle, cysts in ejaculatory duct, prostatic calculi, ejaculatory duct calculi, and seminal vesicle dilation. Compared with age-matched controls, symptomatic patients had significantly increased prevalence of the abnormal findings on the transrectal ultrasonography (p <0.01 ). Ejaculatory duct calculi were significantly associated with bladder outlet obstructive symptoms and bladder irritative symptoms (p <0.05), and seminal vesicle dilation was also significantly associated with pain (p <0.05). Prostatic calculi and ejaculatory duct calculi were closely associated with voiding dysfunction, however, cyst in seminal vesicle and ejaculatory duct were closely associated with pain. Transrectal ultrasonography offers clinical insights into the causes of distressing genitourinary symptoms, and may be helpful in their management.

Evaluation of distribution and size of prostatic calculi in prostatism / 대한비뇨기과학회지

Prostatic calculosis is a physiological feature of the aging process, but it plays an important role in prostatic diseases. Recently we have evaluated the size and location of prostatic calculi in 314 patients with prostatic disease during the period from Aug. 1991 to Feb. 1992 using transrectal ultrasonogram. Prostatic calculi over 3 mm in diameter (with strone echo and posterior acoustic shadow) were observed 12% (3/26) in normal control group, 26% (47/170) in BPH and 20% (17/85) in chronic prostatitis. The incidence or size of prostatic calculi were increased with age. We classifed the calculi "central", when calculus located around the verumontanum or prostatic urethra and "peripheral", when calculus located peripherally. 76% of calculi with prostatitis were located centrally but 59% of calculi with BPH were located peripherally. 69% of calculi with symptom group (patients who complain of voiding dysfunction in 60 years or elder age group without BPH or other urologic diseases) were located centally. Prostatic calculi were also observed in four patients with hematospermia (4/6) and in five patients with-ejaculatory duct cyst (5/6). These results indicate that all prostatic calculi were not asymptomatic and transrectal ultrasonogram should be done to evaluate prostatism. The treatment modality can be chosen and the prognosis estimated by knowing the location and size of prostatic calculi.