Painless lump in the scrotum
Introduction
Introduction Painless scrotal mass: In the courtyard of the scrotum, usually only members of the testis, epididymis, and spermatic cord are inhabited, but sometimes strange faces appear, one of which is seminal vesiculitis. It is more common in middle-aged people. Seminal vesiculitis is a cystic, painless or mild pain, sometimes accompanied by a scrotal mass with a sense of falling, containing sperm and fluid.
Cause
Cause
(1) Causes of the disease
There are several routes of infection of seminal vesicles: 1 retrograde infection through the urethra, the most common; 2 prostatic infection spread; 3 infection through the vas deferens; 4 blood and lymphatic infection. The pathogens include Staphylococcus aureus, Streptococcus, Escherichia coli, and Corynebacterium diphtheriae; and can also be caused by Trichomonas, Mycobacterium tuberculosis, and Neisseria gonorrhoeae.
(two) pathogenesis
Due to the particularity of the anatomical location of the seminal vesicles, most scholars believe that seminal vesiculitis is closely related to prostatitis, often occurring simultaneously or simultaneously, and is associated with inflammation of other organs of the genitourinary system. Due to the characteristics of the tissue structure, the seminal vesicles have many discs and mucosal folds, which are easy to drain, and the bacteria are not easily eliminated. Fructose is a good medium for bacteria, so acute seminal vesiculitis is not completely treated and can be prolonged. Chronic seminal vesiculitis; can also be caused by frequent excitement or masturbation, causing chronic congestion and edema of the prostate and seminal vesicle, secondary infection causing chronic seminal vesiculitis.
Examine
an examination
Related inspection
Scrotal examination semen examination scrotum imaging
Acute seminal vesiculitis
(1) People who have been infected with blood may have chills, fever, body aches and symptoms of lower abdominal pain. Transurethral retrograde infection has frequent urination, urgency, dysuria, perineum and rectal pain.
(2) The rectal examination can reach the enlargement of the seminal vesicle, and the tenderness is obvious. The abscess formation may have a sense of fluctuation.
2. Chronic seminal vesicle
(1) Blood sperm: This is often a feature of chronic seminal vesiculitis. The appearance of semen is pink, dark red or brown, and a few are accompanied by old crumb-like blood clots. Blood is often difficult to stop, and it will last for several months. Most patients have no ejaculation pain.
(2) Sexual dysfunction: Many people are afraid of blood and avoid sexual intercourse. Those with longer time often have decreased libido, frequent spermatorrhea and premature ejaculation.
(3) urinary tract symptoms: Most patients have no obvious urinary tract irritation, more complaints of perineal and lower abdominal discomfort, some patients have urinary tract burning sensation, primary hematuria after ejaculation.
(4) Neurological symptoms: Because of fear of the influence of blood essence on the health of themselves and their spouses, they are worried about affecting fertility, so the burden of thought is heavier. Patients often feel dizzy and weak, and the course of the disease is particularly obvious.
(5) digital rectal examination: the obese people often palpation of the seminal vesicles, some patients can have a slightly harder texture of the seminal vesicles, increase and tenderness, the boundaries of the seminal vesicles are unclear around the adhesion.
According to the typical clinical manifestations, the possibility of seminal vesiculitis should be considered and it needs to be differentiated from prostatitis. Semen examination is important for diagnosis and can be diagnosed as bacterial seminal vesiculitis in combination with imaging examination.
Diagnosis
Differential diagnosis
Should be differentiated from scrotal enlargement and scrotal mass.
Scrotal enlargement refers to the lesion of the scrotal skin and its contents (sheath, testis, epididymis and spermatic cord), or the contents of the abdominal cavity (ascites, internal organs) and the like fall into the scrotum, resulting in an increase in the size of the scrotum.
Swelling of the scrotum refers to the lesion of the scrotal skin and its contents (the sheath testis, epididymis and spermatic cord), or the contents of the abdominal cavity (ascites viscera) descending into the scrotum, resulting in an increase in the size of the scrotum.
Acute seminal vesiculitis
(1) People who have been infected with blood may have chills, fever, body aches and symptoms of lower abdominal pain. Transurethral retrograde infection has frequent urination, urgency, dysuria, perineum and rectal pain.
(2) The rectal examination can reach the enlargement of the seminal vesicle, and the tenderness is obvious. The abscess formation may have a sense of fluctuation.
2. Chronic seminal vesicle
(1) Blood sperm: This is often a feature of chronic seminal vesiculitis. The appearance of semen is pink, dark red or brown, and a few are accompanied by old crumb-like blood clots. Blood is often difficult to stop, and it will last for several months. Most patients have no ejaculation pain.
(2) Sexual dysfunction: Many people are afraid of blood and avoid sexual intercourse. Those with longer time often have decreased libido, frequent spermatorrhea and premature ejaculation.
(3) urinary tract symptoms: Most patients have no obvious urinary tract irritation, more complaints of perineal and lower abdominal discomfort, some patients have urinary tract burning sensation, primary hematuria after ejaculation.
(4) Neurological symptoms: Because of fear of the influence of blood essence on the health of themselves and their spouses, they are worried about affecting fertility, so the burden of thought is heavier. Patients often feel dizzy and weak, and the course of the disease is particularly obvious.
(5) digital rectal examination: the obese people often palpation of the seminal vesicles, some patients can have a slightly harder texture of the seminal vesicles, increase and tenderness, the boundaries of the seminal vesicles are unclear around the adhesion.
According to the typical clinical manifestations, the possibility of seminal vesiculitis should be considered and it needs to be differentiated from prostatitis. Semen examination is important for diagnosis and can be diagnosed as bacterial seminal vesiculitis in combination with imaging examination.
