Seminal vesiculography: limited value in vesiculitis.

Seminal vesiculograms were performed on 44 men being evaluated for chronic perineal pain consistent with seminal vesiculitis. The vesiculograms were performed prior to antibiotic instillation into the vas deferens. Vesiculograms were abnormal in 32 of the 44 patients (73%). The most common abnormality was the presence of multiple small diverticula producing a feathery appearance of the vas deferens (64%), a finding present in only 19 per cent of patients being evaluated for infertility and 20 per cent of normal patients. Asymmetry and incomplete filling of the seminal vesicles were less common abnormalities. Seventeen of these patients had seminal vesiculectomies for persistent or recurrent pain, and 15 have been followed long enough to assess the results. The histologic examination of the excised seminal vesicles was abnormal in only 3 patients (20%), despite radiographic abnormalities in 10 (67%) and improvement after surgery in 12 (80%). Seminal vesiculography may be useful to exclude anatomic abnormalities prior to instillation, but does not appear sufficiently specific to warrant use as the primary diagnostic examination for patients suspected of having seminal vesiculitis.