Laparoscopic and Robotic Surgery of the Seminal Vesicles

The seminal vesicles are paired glands that lie immediately superior and posterior to the prostate; they function to produce and store seminal fluid. Symptoms attributable to seminal vesicle pathology, such as pelvic pain, pain with ejaculation, hematospermia, lower urinary tract symptoms, hematuria, or infertility, may require further evaluation. Physical examination is limited and diagnostic imaging (e.g. transrectal ultrasound or cross-sectional imaging) may be required to identify seminal vesicle disease. Benign conditions, including stones, infection, or cysts, require surgical intervention if symptoms cannot be managed medically. Cysts may be congenital, as a result of Wolffian duct anomalies, or acquired due to chronic ejaculatory duct obstruction. Although tumors of the seminal vesicle are typically benign, surgical intervention is warranted as benign tumors cannot be distinguished from malignant tumors by imaging alone. Endoscopic surgery can be considered for benign conditions; however, laparoscopic or robotic extirpation is necessary for seminal vesicle tumors. Successful surgical intervention of the seminal vesicles requires an understanding of its anatomic relationships to surrounding structures.