- Email: [email protected]
Seminal Vesiculitis
Vet Clin Food Anim 24 (2008) 267–272
Seminal Vesiculitis Bruce L. Hull, DVM, MS*, Susan R. Vogel, DVM The Ohio State University, 1935 Coffey Road, Columbus, OH 43210, USA
The issue of fertility typically is not seminal vesiculitis, because seminal vesiculitis has been described in a number of previous papers [1–8]. Seminal vesiculitis is an inflammation of the seminal vesicle. The inflammatory process associated with seminal vesiculitis often results in the presence of white blood cells (pus) in the semen, which renders the bull an unsatisfactory potential breeder. A second and equally important problem is diagnosing seminal vesiculitis as the origin of the pus. Inflammation of the seminal vesicles may be independent or may be accompanied by inflammation of associated urogenital tissues. As such, successful treatment is dependent on accurate diagnosis. The third problem is how to treat the infected seminal vesicle.
Diagnosis Seminal vesiculitis in bulls is usually first diagnosed during a breeding soundness examination. If pus is observed in the ejaculate, one should rule out inflammatory conditions of the penis and prepuce as the source of the pus. Once these have been ruled out, careful evaluation of the entire reproductive tract must be performed. In seminal vesiculitis, rectal palpation of the pelvic genitalia usually reveals that one or both seminal vesicles are firm and fibrotic. They may be enlarged and have less distinct lobulations than normal. Infrequently, an inflamed vesicle has a palpable abscess. Application of digital pressure to the affected vesicle may elicit a mild sensitive response, although it is not unusual for a pain response to be absent. In more chronic cases there may be adhesions of the vesicles to surrounding tissues. Examination of the seminal vesicles with transrectal ultrasound is helpful in obtaining a diagnosis.
* Corresponding author. E-mail address: [email protected] (B.L. Hull). 0749-0720/08/$ - see front matter Ó 2008 Elsevier Inc. All rights reserved. doi:10.1016/j.cvfa.2008.02.006 vetfood.theclinics.com
268
HULL & VOGEL
The criteria for diagnosis of seminal vesiculitis are subjective and are dependent almost entirely on rectal palpation and ultrasound and are dependent on the ability to detect slight variations from the normal. Seminal vesiculitis may often be accompanied by inflammation of other associated urogenital tissues, such as ampullae, epididymides, testicles, prostate, bulbourethral glands, and the urethra. The inexact method of diagnosis and the inflammation of associated tissues may often explain treatment failures. The incidence of seminal vesiculitis has generally been reported to be between 0.85% and 10% [7,8]. Close confinement and the feeding of highenergy diets seem to be associated with a higher prevalence of the disease [7,8]. Although most bulls affected are young bulls, a more chronic form has been reported in older bulls [7]. Spontaneous recovery has been reported in some young bulls [4,7,9].
Etiology Historically, Brucella abortus has been commonly reported as a cause of seminal vesiculitis, but as brucellosis has become more controlled it seems that Arcanobacter pyogenes is now the most common etiologic agent isolated [8,9]. Many other organisms have been isolated in cases of seminal vesiculitis. It is also possible that viruses play a role in the etiology, although presently this is unclear [8].
Pathogenesis Several theories have been suggested for the pathogenesis of seminal vesiculitis in the bovine; however, the exact pathogenesis is still uncertain [4,5,8]. Theories include 1. Ascending infection, by way of the urethra. 2. A descending infection from the testes, epididymis, prostate, or ampullae. 3. Hematogenous spread from other sites of inflammation. 4. Congenital abnormalities affecting the normal function of the seminal colliculus resulting in reflux of urine into the seminal vesicles.
Surgical anatomy Seminal vesicles are paired accessory glands located just cranial to the prostate, lateral to the ampullae, and dorsal to the bladder. The seminal vesicles are readily palpated per rectum and should be 4 to 6 inches in length and 1 to 1.5 inches in diameter in the mature bull. The free portion of each seminal vesicle is located cranially, whereas the ejaculatory duct of the seminal vesicle enters the urethra near the prostate. The cranial free portion
SEMINAL VESICULITIS
269
of the seminal vesicle lies in close proximity to the caudal reflection of the peritoneal surface. This close proximity becomes very important during surgical dissection of the seminal vesicles.
Treatment Age of the animal, value of the animal, and the possibility of spontaneous recovery in young animals must all be considered before embarking on a treatment regime. Over the years various treatment protocols have been used to treat seminal vesiculitis. The initial treatment has often been antibiotic administration. Antibiotics may be administered orally, systemically, or by intravesicular injection. If one is to use antibiotics they must be administered for at least 2 to 4 weeks. Culture (taken after appropriate cleansing and catheterization) and sensitivity of a seminal specimen may increase the effectiveness of antibiotic treatment [4,7,8], as might the inclusion of antiinflammatory drugs in the therapeutic regime. Although antibiotics seldom cure seminal vesiculitis they may yield remission, which is lengthy enough to allow collection and freezing of semen [8]. Injection of sclerosing agents into the vesicle has been proposed [6,10]. The sclerosing agent causes local irritation and inflammation in the injected tissues. This inflammation usually lasts from 2 to 4 weeks and may be extensive. It is extremely important that injection of the sclerosing agent be into the ejaculatory duct area of the seminal vesicle, because injection into the surrounding tissues may lead to disastrous consequences. Injection of sclerosing agents into the base of the seminal vesicles has yielded mixed results [4,6]. Changes in seminal pH accompanied by poor quality semen have been observed after such injection by one author [11].
Seminal vesiculectomy Surgical removal of the seminal vesicles is another option. Traditionally, seminal vesicles have been removed through an incision in the ischiorectal fossa. The nerves and vessels that supply the rectum, pelvic urethra, urinary bladder, accessory sex glands, and the penis pass through the muscles along the lateral walls of the rectum and pelvic urethra [12]. Using a combination of sharp and blunt dissection, the seminal vesicles are approached and freed from the surrounding tissues. Once freed, the seminal vesicles are ligated and removed. This technique is not without its problems. The biggest problem is postoperative hemorrhage. This hemorrhage is often severe and because of its location may be difficult or impossible to control. If this resulting hematoma is seeded by bacterial flora while removing the seminal vesicles, large pelvic abscesses may develop. Another problem observed has been interference with pelvic innervation, which subsequently may lead to bladder atony or an inability of the bull to ejaculate following surgery.
270
HULL & VOGEL
The overall success rate of the traditional seminal vesiculectomy is poor [7]. The newer ventral pararectal approach seems to be preferable and has a reported success rate of 55% to 80% (William Stone, unpublished observations, 1996) [11,12]. Antibiotics should be administered for 1 to 2 days preoperatively and should continue for at least 5 days after surgery. Although the specific antibiotic used is the surgeon’s prerogative, procaine penicillin or ampicillin seems to be appropriate. Ideally, antibiotics should also be chosen on the basis of previous culture and sensitivity. Culture and sensitivity should be taken in a clean manner as described by Larson [7]. Local anesthesia may be achieved by epidural injection with 4 to 8 mL of lidocaine or xylocaine depending on the size of the individual animal. The temperament of the animal may also warrant the use of tranquilizers. Care must be taken in choosing and administering a tranquilizer because it must be remembered that this surgery is easier to perform while the animal still standing [11]. This surgery has also been performed in lateral recumbency with general anesthesia [12]. The rectum is manually evacuated as far forward as possible, cleaned with a dilute povidone-iodine solution, and packed off with a large cotton tampon saturated in dilute povidone-iodine solution. The authors usually pack the roll cotton into a 6-inch stockinet to make for easier removal after surgery. This tampon is placed as far forward into the rectum as possible. Once the rectum has been packed, the tail is elevated and tied above the bull. The perineal region is then clipped, prepared for surgery, and draped. A vertical incision, which transects the anal sphincter, is made at the 6-o’clock position. This incision extends ventrally to the ischial arch and extends anterior into the rectum for a distance of 8 to 15 cm [11,12]. This incision extends to the depth of the urethralis muscle. Once this incision is made, it can be held open with towel forceps placed at the 4- and 8-o’clock positions. Blunt dissection is now used to carry the incision forward along the penis to the seminal vesicles. Although one is tempted to use sharp dissection at times, sharp dissection should be avoided if possible to minimize hemorrhage [11]. Any hemorrhage encountered from now until the end of the surgery is very difficult to control and may lead to unacceptable results. Once the seminal vesicles are identified they must be gently and bluntly freed from the surrounding tissue. Usually this can be accomplished without invading the peritoneal space if care is exercised [11]. Once the free portion of the seminal vesicle is freed, dissection is continued until each seminal vesicle is only attached to the penis by its narrow ejaculatory duct. Both seminal vesicles should be freed before removing either one. Although it has been suggested that the seminal vesicles should be ligated with a transfixion suture as close to the penis as possible [5,12], this is extremely difficult to perform. It is preferable to remove each seminal vesicle with a chain ecraseur as close to the penis as possible [11]. Using a chain ecraseur leaves a smaller ‘‘stump’’ of seminal vesicle tissue than the transfixation and ligation
SEMINAL VESICULITIS
271
technique. Once one seminal vesicle is removed, the procedure is repeated on the opposite side. The muscularis and submucosa of the rectum are closed with a continuous Lembert suture pattern of absorbable suture. The authors use #1 chromic catgut for this, although other absorbable sutures are certainly acceptable. Extreme care should be used in placing this suture to ensure that the rectal mucosa is not penetrated. There should be no suture material exposed in the lumen of the rectum. As the rectum is closed it is tacked down to the surrounding tissues to eliminate ‘‘dead space.’’ The anal sphincter is reconstructed with interrupted horizontal mattress sutures using absorbable suture material. The perineal skin is closed with a continuous interlocking pattern of nonabsorbable suture. At the conclusion of surgery the tampon is pulled posterior within the rectum adjacent to the area of the seminal vesicles and left for several hours before eventual removal. This tampon applies pressure to the surgical area and in the author’s opinion seems to help control hemorrhage. As with previous surgical techniques for the removal of seminal vesicles, hemorrhage still seems to be the biggest complicating factor. By the very nature of the surgery (removing an infected part), large hematomas have a tendency to become infected and develop into large pelvic abscesses. It should be noted that with seminal vesiculectomy (both the old technique and the new technique), large hematomas seem to be more prevalent in older bulls, and indeed seminal vesiculectomy cannot be recommended as a treatment for older bulls at this time [11]. In the past, seminal vesiculectomy has not been very successful and the industry standard has been to cull bulls with seminal vesiculitis. The biggest problems associated with seminal vesiculectomy previously have been large pelvic hematomas with secondary abscesses or continued pus in the semen after surgery. The new technique for removal of the seminal vesicles provides superior exposure for removal of the vesicles. With this improved exposure, dissection to remove the vesicles can be more precise, and dissection can usually be carried closer to the attachment of the vesicle to the penis. This leaves less of a vesicular stump potentially to act as a focus for continued infection. The superior exposure for dissection also makes it easier to free the vesicles without creating hemorrhage. Follow-up In one paper, four of five seminal vesiculectomies in yearling bulls were successful in eliminating pus from the semen [11]. The fifth bull continued to have pus in the ejaculate. This bull had normal seminal vesicles on histopathology, however, and on follow-up examination had an enlarged left ampulla that was hyperechoic on ultrasound. Postmortem of this bull revealed ampullitis of the left ampulla. This underscores the statement in the introduction that one of the problems in seminal vesiculitis is accurate diagnosis.
272
HULL & VOGEL
Several papers report decreased semen volume, motility, percentage live cells, and primary defects, but an increase in secondary morphologic abnormalities after seminal vesiculectomy [11,13,14]. Two papers report adequate fertility after seminal vesiculectomy and elimination of the purulent exudates from the semen [11,13]. One paper reports that semen can be successfully frozen and was acceptable for AI use post–seminal vesiculectomy [11].
Summary Although accurate diagnosis of seminal vesiculitis still seems to be a problem, the disease can be treated surgically if the value of the animal warrants. Although this technique offers superior surgical exposure and seems to be successful in young bulls, its value in adult bulls is still questionable. There have been no reports of successful seminal vesiculectomy in aged bulls of which the authors are aware.
References [1] Ball L, Griner LA, Carroll EJ. The bovine seminal vesiculitis syndrome. Am J Vet Res 1964; 25:291–301. [2] Ball L, Young S, Carroll EJ. Seminal vesiculitis syndrome: lesions in genital organs of young bulls. Am J Vet Res 1968;29:1173–83. [3] Blom E. Studies on seminal vesiculitis in the bull. I. Semen examination methods and post mortem findings. Nord Vet Med 1979;31:193–205. [4] Monke DR. Bovine seminal vesiculitis. In: Proceedings, 10th Technical Conference on Artificial Insemination and Reproduction, National Association of Animal Breeders. Columbia (MO): National Association of Breeders; 1984. p. 54–61. [5] Linhart RD, Parker WG. Seminal vesiculitis in bulls. Compendium for Continuing Education 1988;10:1427–48. [6] Hoover TR. A technique for injecting into the seminal vesicles of the bull. Am J Vet Res 1974; 35:1135–6. [7] Larson RL. Diagnosing and controlling seminal vesiculitis in bulls. Vet Med 1997;92:1073–8. [8] Cavalieri J, VanCamp SD. Bovine seminal vesiculitis, a review and update. Vet Clin North Am Food Anim Pract 1997;13(2):233–41. [9] Martinez MF, Barth AD. Early detection and treatment of vesicular adenitis in bulls. Anim Reprod Sci 2007;101:252–6. [10] Waguespack RW, Schumacher J, Wolfe DF, et al. Preliminary study to evaluate the feasibility of chemical ablation of the seminal vesicles in the bull. In: Smith R, editor. Proceedings of American Association of Bovine Practitioners; 2004. p. 295–6. [11] Hull BL, Monke DR, Rohde R. A new technique for seminal vesiculectomy. In: Proceedings of the 14th Technical Conference on Artificial Insemination and Reproduction. Milwaukee (Wisconsin): 1992. p. 100–3. [12] Hooper RN, Taylor TS, Blanchard TL, et al. Ventral pararectal approach to the seminal vesicles of bulls. J Am Vet Med Assoc 1994;205:596–9. [13] Faulkner LC, Hopwood ML, Wiltbank JN. Seminal vesiculectomy in bulls. II. Seminal characteristics and breeding trials. J Reprod Fertil 1968;16:179–82. [14] Nothling JO, Volkman DH. Dilation of the ampullae and an increased incidence of loose sperm heads after bilateral vesiculectomy in a bull. Reproduction of Domestic Animals 1997;32:321–4.
Seminal Vesiculitis Bruce L. Hull, DVM, MS*, Susan R. Vogel, DVM The Ohio State University, 1935 Coffey Road, Columbus, OH 43210, USA
The issue of fertility typically is not seminal vesiculitis, because seminal vesiculitis has been described in a number of previous papers [1–8]. Seminal vesiculitis is an inflammation of the seminal vesicle. The inflammatory process associated with seminal vesiculitis often results in the presence of white blood cells (pus) in the semen, which renders the bull an unsatisfactory potential breeder. A second and equally important problem is diagnosing seminal vesiculitis as the origin of the pus. Inflammation of the seminal vesicles may be independent or may be accompanied by inflammation of associated urogenital tissues. As such, successful treatment is dependent on accurate diagnosis. The third problem is how to treat the infected seminal vesicle.
Diagnosis Seminal vesiculitis in bulls is usually first diagnosed during a breeding soundness examination. If pus is observed in the ejaculate, one should rule out inflammatory conditions of the penis and prepuce as the source of the pus. Once these have been ruled out, careful evaluation of the entire reproductive tract must be performed. In seminal vesiculitis, rectal palpation of the pelvic genitalia usually reveals that one or both seminal vesicles are firm and fibrotic. They may be enlarged and have less distinct lobulations than normal. Infrequently, an inflamed vesicle has a palpable abscess. Application of digital pressure to the affected vesicle may elicit a mild sensitive response, although it is not unusual for a pain response to be absent. In more chronic cases there may be adhesions of the vesicles to surrounding tissues. Examination of the seminal vesicles with transrectal ultrasound is helpful in obtaining a diagnosis.
* Corresponding author. E-mail address: [email protected] (B.L. Hull). 0749-0720/08/$ - see front matter Ó 2008 Elsevier Inc. All rights reserved. doi:10.1016/j.cvfa.2008.02.006 vetfood.theclinics.com
268
HULL & VOGEL
The criteria for diagnosis of seminal vesiculitis are subjective and are dependent almost entirely on rectal palpation and ultrasound and are dependent on the ability to detect slight variations from the normal. Seminal vesiculitis may often be accompanied by inflammation of other associated urogenital tissues, such as ampullae, epididymides, testicles, prostate, bulbourethral glands, and the urethra. The inexact method of diagnosis and the inflammation of associated tissues may often explain treatment failures. The incidence of seminal vesiculitis has generally been reported to be between 0.85% and 10% [7,8]. Close confinement and the feeding of highenergy diets seem to be associated with a higher prevalence of the disease [7,8]. Although most bulls affected are young bulls, a more chronic form has been reported in older bulls [7]. Spontaneous recovery has been reported in some young bulls [4,7,9].
Etiology Historically, Brucella abortus has been commonly reported as a cause of seminal vesiculitis, but as brucellosis has become more controlled it seems that Arcanobacter pyogenes is now the most common etiologic agent isolated [8,9]. Many other organisms have been isolated in cases of seminal vesiculitis. It is also possible that viruses play a role in the etiology, although presently this is unclear [8].
Pathogenesis Several theories have been suggested for the pathogenesis of seminal vesiculitis in the bovine; however, the exact pathogenesis is still uncertain [4,5,8]. Theories include 1. Ascending infection, by way of the urethra. 2. A descending infection from the testes, epididymis, prostate, or ampullae. 3. Hematogenous spread from other sites of inflammation. 4. Congenital abnormalities affecting the normal function of the seminal colliculus resulting in reflux of urine into the seminal vesicles.
Surgical anatomy Seminal vesicles are paired accessory glands located just cranial to the prostate, lateral to the ampullae, and dorsal to the bladder. The seminal vesicles are readily palpated per rectum and should be 4 to 6 inches in length and 1 to 1.5 inches in diameter in the mature bull. The free portion of each seminal vesicle is located cranially, whereas the ejaculatory duct of the seminal vesicle enters the urethra near the prostate. The cranial free portion
SEMINAL VESICULITIS
269
of the seminal vesicle lies in close proximity to the caudal reflection of the peritoneal surface. This close proximity becomes very important during surgical dissection of the seminal vesicles.
Treatment Age of the animal, value of the animal, and the possibility of spontaneous recovery in young animals must all be considered before embarking on a treatment regime. Over the years various treatment protocols have been used to treat seminal vesiculitis. The initial treatment has often been antibiotic administration. Antibiotics may be administered orally, systemically, or by intravesicular injection. If one is to use antibiotics they must be administered for at least 2 to 4 weeks. Culture (taken after appropriate cleansing and catheterization) and sensitivity of a seminal specimen may increase the effectiveness of antibiotic treatment [4,7,8], as might the inclusion of antiinflammatory drugs in the therapeutic regime. Although antibiotics seldom cure seminal vesiculitis they may yield remission, which is lengthy enough to allow collection and freezing of semen [8]. Injection of sclerosing agents into the vesicle has been proposed [6,10]. The sclerosing agent causes local irritation and inflammation in the injected tissues. This inflammation usually lasts from 2 to 4 weeks and may be extensive. It is extremely important that injection of the sclerosing agent be into the ejaculatory duct area of the seminal vesicle, because injection into the surrounding tissues may lead to disastrous consequences. Injection of sclerosing agents into the base of the seminal vesicles has yielded mixed results [4,6]. Changes in seminal pH accompanied by poor quality semen have been observed after such injection by one author [11].
Seminal vesiculectomy Surgical removal of the seminal vesicles is another option. Traditionally, seminal vesicles have been removed through an incision in the ischiorectal fossa. The nerves and vessels that supply the rectum, pelvic urethra, urinary bladder, accessory sex glands, and the penis pass through the muscles along the lateral walls of the rectum and pelvic urethra [12]. Using a combination of sharp and blunt dissection, the seminal vesicles are approached and freed from the surrounding tissues. Once freed, the seminal vesicles are ligated and removed. This technique is not without its problems. The biggest problem is postoperative hemorrhage. This hemorrhage is often severe and because of its location may be difficult or impossible to control. If this resulting hematoma is seeded by bacterial flora while removing the seminal vesicles, large pelvic abscesses may develop. Another problem observed has been interference with pelvic innervation, which subsequently may lead to bladder atony or an inability of the bull to ejaculate following surgery.
270
HULL & VOGEL
The overall success rate of the traditional seminal vesiculectomy is poor [7]. The newer ventral pararectal approach seems to be preferable and has a reported success rate of 55% to 80% (William Stone, unpublished observations, 1996) [11,12]. Antibiotics should be administered for 1 to 2 days preoperatively and should continue for at least 5 days after surgery. Although the specific antibiotic used is the surgeon’s prerogative, procaine penicillin or ampicillin seems to be appropriate. Ideally, antibiotics should also be chosen on the basis of previous culture and sensitivity. Culture and sensitivity should be taken in a clean manner as described by Larson [7]. Local anesthesia may be achieved by epidural injection with 4 to 8 mL of lidocaine or xylocaine depending on the size of the individual animal. The temperament of the animal may also warrant the use of tranquilizers. Care must be taken in choosing and administering a tranquilizer because it must be remembered that this surgery is easier to perform while the animal still standing [11]. This surgery has also been performed in lateral recumbency with general anesthesia [12]. The rectum is manually evacuated as far forward as possible, cleaned with a dilute povidone-iodine solution, and packed off with a large cotton tampon saturated in dilute povidone-iodine solution. The authors usually pack the roll cotton into a 6-inch stockinet to make for easier removal after surgery. This tampon is placed as far forward into the rectum as possible. Once the rectum has been packed, the tail is elevated and tied above the bull. The perineal region is then clipped, prepared for surgery, and draped. A vertical incision, which transects the anal sphincter, is made at the 6-o’clock position. This incision extends ventrally to the ischial arch and extends anterior into the rectum for a distance of 8 to 15 cm [11,12]. This incision extends to the depth of the urethralis muscle. Once this incision is made, it can be held open with towel forceps placed at the 4- and 8-o’clock positions. Blunt dissection is now used to carry the incision forward along the penis to the seminal vesicles. Although one is tempted to use sharp dissection at times, sharp dissection should be avoided if possible to minimize hemorrhage [11]. Any hemorrhage encountered from now until the end of the surgery is very difficult to control and may lead to unacceptable results. Once the seminal vesicles are identified they must be gently and bluntly freed from the surrounding tissue. Usually this can be accomplished without invading the peritoneal space if care is exercised [11]. Once the free portion of the seminal vesicle is freed, dissection is continued until each seminal vesicle is only attached to the penis by its narrow ejaculatory duct. Both seminal vesicles should be freed before removing either one. Although it has been suggested that the seminal vesicles should be ligated with a transfixion suture as close to the penis as possible [5,12], this is extremely difficult to perform. It is preferable to remove each seminal vesicle with a chain ecraseur as close to the penis as possible [11]. Using a chain ecraseur leaves a smaller ‘‘stump’’ of seminal vesicle tissue than the transfixation and ligation
SEMINAL VESICULITIS
271
technique. Once one seminal vesicle is removed, the procedure is repeated on the opposite side. The muscularis and submucosa of the rectum are closed with a continuous Lembert suture pattern of absorbable suture. The authors use #1 chromic catgut for this, although other absorbable sutures are certainly acceptable. Extreme care should be used in placing this suture to ensure that the rectal mucosa is not penetrated. There should be no suture material exposed in the lumen of the rectum. As the rectum is closed it is tacked down to the surrounding tissues to eliminate ‘‘dead space.’’ The anal sphincter is reconstructed with interrupted horizontal mattress sutures using absorbable suture material. The perineal skin is closed with a continuous interlocking pattern of nonabsorbable suture. At the conclusion of surgery the tampon is pulled posterior within the rectum adjacent to the area of the seminal vesicles and left for several hours before eventual removal. This tampon applies pressure to the surgical area and in the author’s opinion seems to help control hemorrhage. As with previous surgical techniques for the removal of seminal vesicles, hemorrhage still seems to be the biggest complicating factor. By the very nature of the surgery (removing an infected part), large hematomas have a tendency to become infected and develop into large pelvic abscesses. It should be noted that with seminal vesiculectomy (both the old technique and the new technique), large hematomas seem to be more prevalent in older bulls, and indeed seminal vesiculectomy cannot be recommended as a treatment for older bulls at this time [11]. In the past, seminal vesiculectomy has not been very successful and the industry standard has been to cull bulls with seminal vesiculitis. The biggest problems associated with seminal vesiculectomy previously have been large pelvic hematomas with secondary abscesses or continued pus in the semen after surgery. The new technique for removal of the seminal vesicles provides superior exposure for removal of the vesicles. With this improved exposure, dissection to remove the vesicles can be more precise, and dissection can usually be carried closer to the attachment of the vesicle to the penis. This leaves less of a vesicular stump potentially to act as a focus for continued infection. The superior exposure for dissection also makes it easier to free the vesicles without creating hemorrhage. Follow-up In one paper, four of five seminal vesiculectomies in yearling bulls were successful in eliminating pus from the semen [11]. The fifth bull continued to have pus in the ejaculate. This bull had normal seminal vesicles on histopathology, however, and on follow-up examination had an enlarged left ampulla that was hyperechoic on ultrasound. Postmortem of this bull revealed ampullitis of the left ampulla. This underscores the statement in the introduction that one of the problems in seminal vesiculitis is accurate diagnosis.
272
HULL & VOGEL
Several papers report decreased semen volume, motility, percentage live cells, and primary defects, but an increase in secondary morphologic abnormalities after seminal vesiculectomy [11,13,14]. Two papers report adequate fertility after seminal vesiculectomy and elimination of the purulent exudates from the semen [11,13]. One paper reports that semen can be successfully frozen and was acceptable for AI use post–seminal vesiculectomy [11].
Summary Although accurate diagnosis of seminal vesiculitis still seems to be a problem, the disease can be treated surgically if the value of the animal warrants. Although this technique offers superior surgical exposure and seems to be successful in young bulls, its value in adult bulls is still questionable. There have been no reports of successful seminal vesiculectomy in aged bulls of which the authors are aware.
References [1] Ball L, Griner LA, Carroll EJ. The bovine seminal vesiculitis syndrome. Am J Vet Res 1964; 25:291–301. [2] Ball L, Young S, Carroll EJ. Seminal vesiculitis syndrome: lesions in genital organs of young bulls. Am J Vet Res 1968;29:1173–83. [3] Blom E. Studies on seminal vesiculitis in the bull. I. Semen examination methods and post mortem findings. Nord Vet Med 1979;31:193–205. [4] Monke DR. Bovine seminal vesiculitis. In: Proceedings, 10th Technical Conference on Artificial Insemination and Reproduction, National Association of Animal Breeders. Columbia (MO): National Association of Breeders; 1984. p. 54–61. [5] Linhart RD, Parker WG. Seminal vesiculitis in bulls. Compendium for Continuing Education 1988;10:1427–48. [6] Hoover TR. A technique for injecting into the seminal vesicles of the bull. Am J Vet Res 1974; 35:1135–6. [7] Larson RL. Diagnosing and controlling seminal vesiculitis in bulls. Vet Med 1997;92:1073–8. [8] Cavalieri J, VanCamp SD. Bovine seminal vesiculitis, a review and update. Vet Clin North Am Food Anim Pract 1997;13(2):233–41. [9] Martinez MF, Barth AD. Early detection and treatment of vesicular adenitis in bulls. Anim Reprod Sci 2007;101:252–6. [10] Waguespack RW, Schumacher J, Wolfe DF, et al. Preliminary study to evaluate the feasibility of chemical ablation of the seminal vesicles in the bull. In: Smith R, editor. Proceedings of American Association of Bovine Practitioners; 2004. p. 295–6. [11] Hull BL, Monke DR, Rohde R. A new technique for seminal vesiculectomy. In: Proceedings of the 14th Technical Conference on Artificial Insemination and Reproduction. Milwaukee (Wisconsin): 1992. p. 100–3. [12] Hooper RN, Taylor TS, Blanchard TL, et al. Ventral pararectal approach to the seminal vesicles of bulls. J Am Vet Med Assoc 1994;205:596–9. [13] Faulkner LC, Hopwood ML, Wiltbank JN. Seminal vesiculectomy in bulls. II. Seminal characteristics and breeding trials. J Reprod Fertil 1968;16:179–82. [14] Nothling JO, Volkman DH. Dilation of the ampullae and an increased incidence of loose sperm heads after bilateral vesiculectomy in a bull. Reproduction of Domestic Animals 1997;32:321–4.