SEMINAL-VESICLE CONGESTION AS A CAUSE OF POSTPROSTATECTOMY DYSURIA

A series of benign prostatic hypertrophy patients were routinely evalu ated, including transrectal echography, before and at regular interval s following surgery. Five patients had persistent symptoms of dysuria at 14-30 months after surgery. There was no infection, residual urine or malignancy to explain their symptoms. The seminal vesicles (SVs) we re severely dilated on transrectal echography, a finding which was def initely not present on initial examination. The patients were treated by transrectal echo-guided aspiration of the SVs by the perineal appro ach. The fluid aspirated was examined, and antibiotics were directly i njected into the SVs. In 4 of the patients, there was a dramatic relie f of symptoms with prolonged improvement. In only 1 case, following tr ansurethral resection, there was but slight improvement. Dilated, obst ructed SVs after prostatectomy, clearly diagnosed on transrectal echog raphy, may be the cause of persistent irritative urinary symptoms. Tre atment can be instituted by echo-guided aspiration of the fluid with s imultaneous injection of a potent antibiotic, resulting in probable im mediate relief.