Schistosomiasis of the male genital tract: Transrectal sonographic findings

Purpose: Schistosomal infection of the prostate and seminal vesicles is seldom found in clinical practice and rarely mentioned in the radiological literature. However, the presence of schistosoma eggs has been reported in 50% of postmortem studies of the prostate and seminal vesicles performed in endemic areas. Materials and Methods: We report the results of transrectal studies of the prostate and seminal vesicles performed in 9 white travelers (age less than 35 years) who complained of hemospermia. Diagnosis was confirmed by positive identification of parasites in the urine and semen. Results: Prostatic calcification was observed in 7 cases, hyperechogenic foci in 2, increase in prostate size in 2, calcifications in the seminal vesicles in 1 and dilatation of the seminal vesicles and ejaculatory ducts in 1. After treatment, prostate size and hyperechogenic foci were reduced. In some cases, calcified lesions diminished during followup. Conclusions: Prostatic and seminal calcifications should alert physicians to the possibility of schistosoma infection when they are found in young patients who have been in endemic areas. Parasitological study of semen as well as urine confirms and increases the number of diagnoses.