Case report: tubercular cold abscess of seminal vesicle: minimally invasive endoscopic management.

Abstract:

BACKGROUND:Tubercular cold abscess of the seminal vesicle is very rare, and only a few cases are reported in literature. Preoperative diagnosis is difficult and to the best of our knowledge has not been reported. CASE REPORT:A 35-year-old man presented with a 7-year history of blood in the semen and a reddish brownish discharge per urethra while defecating. On rectal examination, a soft fluctuant mass was felt above the prostate. Abdominal ultrasonography showed cystic swelling of the right seminal vesicle bulging into the posterior bladder wall. Semen examination showed abundant pus cells and 90% immotile sperm with normal morphology. Acid-fast bacilli were not seen, but acid-fast bacilli were found in a 24-hour urine specimen. Cystoscopy showed tubercles in the urethra and brownish discharge from the orifice of the right ejaculatory duct on per-rectal compression of the mass. The abscess cavity was incised with a Collings' knife. Brownish material was evacuated, and the abscess cavity was seen. An 18F Foley catheter was placed for 3 days. Antitubercular therapy was instituted. Ultrasonography repeated after 3, 25, 45, and 75 days showed gradual regression of the abscess cavity. Semen examination after 75 days was normal, with 75% motility, and cystoscopy 45 days postoperatively showed complete healing of the wound. CONCLUSION:The incision connecting the bladder with the abscess cavity facilitated evacuation of pus and complete resolution of the abscess.

journal_name

J Endourol

journal_title

Journal of endourology

authors

Dewani CP,Dewani N,Bhatia D

doi

10.1089/end.2006.20.436

subject

Has Abstract

pub_date

2006-06-01 00:00:00

pages

436-42

issue

6

eissn

0892-7790

issn

1557-900X

journal_volume

20

pub_type

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