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.