Seminal vesicle stones: A diagnosis challenge and their therapeutic advances, a propos of a case ; Litiasis de Vesículas Seminales: un reto Diagnóstico y sus Avances Terapéuticos, A Propósito de un Caso

Purpose Seminal vesicle stones are a rare entity, different associations with anatomic variations like obstruction in ejaculatory ducts have relation with stone formation, these anatomic variations contribute to the aggregation of substances present in seminal liquid. Our purpose is to show a new diagnostic approach and treatment. Materials and Methods The case of a 42-years-old man with a diagnosis of Lofgren syndrome, presented long standing non-specific urinary tract symptoms and perineal pain. Bilateral calcifications in seminal vesicle were observed using urotomography. With these uncommon findings and a symptomatic patient, a review of literature was performed for approach the treatment. Results Seminal vesicle stone does not have specific symptomatology, and can be presented with perineal pain, infertility, painful ejaculation, irritative urinary symptoms. Different factors contribute to stone formation, the main factors are urinary tract obstruction, substances present in seminal liquid (fructose, prostaglandin), urinary reflux and recurrent infections. The gold standard for diagnosis is transrectal ultrasound. Treatments have been changing during the years, the election treatment at the moment is transurethral seminal vesiculoscopy with laser, supported by different case reports in the literature. Conclusions Seminal vesicle stones are rare entities, this pathology should be suspected with perineal pain, painful ejaculation and infertility. Many treatment techniques have been developed, however no standard procedure has been established to manage this entity yet, for this reason the diagnosis is a challenge to the urologist and the treatment depends on experience and equipment available. Copyright © 2018, Sociedad Colombiana de Urología.