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Ultrasound aspects of symptomatic versus asymptomatic forms of male accessory gland inflammation
Author(s) -
La Vignera Sandro,
Crafa Andrea,
Condorelli Rosita A.,
Barbagallo Federica,
Mongioì Laura M.,
Cannarella Rossella,
Compag Michele,
Aversa Antonio,
Calogero Aldo E.
Publication year - 2021
Publication title -
andrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.947
H-Index - 43
eISSN - 2047-2927
pISSN - 2047-2919
DOI - 10.1111/andr.13014
Subject(s) - medicine , epididymitis , ejaculatory duct , asymptomatic , prostate , echogenicity , urology , prostatitis , ectasia , lower urinary tract symptoms , ultrasound , radiology , surgery , seminal vesicle , cancer
Abstract Background The ultrasound (US) evaluation of the male sex accessory gland inflammation (MAGI) helps the clinicians to understand the severity of this condition, allowing them to distinguish the uncomplicated form (prostatitis) from the complicated ones (prostate‐vesiculitis and prostate‐vesiculitis‐epididymitis), as well as the unilateral from the bilateral forms, the fibrosclerotic and the hypertrophic‐congestive form. Objective This retrospective study aimed to evaluate the US features of MAGI patients with active symptoms compared to patients without sexual, voiding, and ejaculatory dysfunction. Materials/Methods To achieve this aim, an analysis of the prevalence of MAGI US criteria was carried out on a very large series of over 500 patients diagnosed with MAGI classified according to the different symptom profile evaluated through a dedicated questionnaire (previously conceived and published by our group) arbitrarily named “structured interview about MAGI” (SI‐MAGI) for sexual, voiding, and ejaculatory disorders reported by these patients. Results The results of this study revealed that US criteria most frequently detected in patients with severe urinary symptoms were the presence of areas of high echogenicity (almost exclusively in the periurethral prostatic zone) together with the presence of single or multiple areas of acinar ectasia of the prostate. The presence of seminal vesicles with polycyclic areas within the glandular lumen separated by hyperechoic septa represented US criterion most frequently detected in patients with severe spontaneous or post‐ejaculate pain. Finally, US criterion most frequently detected in patients with severe sexual dysfunction was the dilation of the periprostatic venous plexus, suggesting the hypothesis of a possible alternative therapeutic approach. Conclusion The data of the present study suggest that symptoms may associate with US signs in patients with MAGI. Also, specific US signs may associate with specific symptoms. Further studies are needed to understand whether patients with specific US signs may in turn benefit from a personalized therapeutic choice.