Tuberculosis of the prostate and seminal vesicles

Tuberculosis of the prostate and seminal vesicles is rare and associated with renal tuberculosis. In 30 per cent of cases, there is a history of pulmonary tuberculosis within 5 years of the onset of genital tuberculosis.

Tuberculosis of one or both seminal vesicles may be found when examining a patient with chronic tuberculosis epididymitis, no symptoms being referable to the internal geni­talia. On rectal examination, the affected vesicle is found to be nodular.

‘When the prostate is involved, rectal examination reveals nodules in one or both lateral lobes. Patients with tuber­culous prostatitis usually present with the following:

  urethral discharge;

  painful, sometimes bloodstained, ejaculation;

  mild ache in the perineum;

  infertility;

  dysuria;

  abscess formation.

Special forms of investigation

Radiography sometimes displays areas of calcification in the prostate and/or the seminal vesicles.

Bacteriological examination of the seminal fluid yields positive cultures for tubercle bacilli.

Treatment

The general treatment is that for tuberculosis. If a prostatic abscess forms it should be drained transurethrally.