Seminal vesicle urinary reflux

Posted by lagnafinc @lagnafinc, Sep 10 9:25am

I recenly had a PSMA scan which lit up my right seminal vesicle like a spotlight....naturally doctors were concerned about metastasis for my prostate cancer. However, I came across a study about something called seminal vesicle urinary reflux which led me to believe that this might be a simple artifact being more and more recognized in guys like me who had had either a TUIP or TURP procedure. This study found that as a side effect of a TUIP or TURP simple urine can leak into the SV, and during a PSMA scan as it happens that urine is radioactive...and will then light up like a spotlight within the SV. Anyone else come across that? Here's a link to that study: https://pubmed.ncbi.nlm.nih.gov/33156046/

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Too-Many | @toomany | Sep 10 11:55am

"Wow"! That's really the very first word that comes to mind, and my sincere thanks for posting it.

For me personally, this revelation could not possibly be more 'timely', since I have a tele-health visit here in about 2-hours with my original (2018) radiation oncologist, to discuss future treatment options for recurrent cancer concentrated largely in the right seminal vesicle, per PSMA-PET scan about two-weeks ago.

Could this in-fact be 'why' the attending radiologist who reviewed the PSMA-PET scan images stated . . . "Intense radiotracer uptake is also present throughout the right seminal vesicle (SUV=21). Findings are compatible with recurrent malignancy. No metastatic disease identified."?

I'm not sure that there's a practical way for me (or others like me) to ever really know with certainty, and to be clear, I never underwent TUIP or TURP, but nonetheless, when reading the entire abstract of that article, I certainly have to wonder?

Here again, this next bit of information is somewhat anecdotal, but immediately after completing that PSMA-PET scan two-weeks ago, I recall asking the technician how it went? And he said the following (I'm paraphrasing him here) . . . 'You did just fine - no movement, no blurring of the images, everything looks just great. You'll get a final report from your referring oncologist, and he'll see some limited but routine uptake of tracer by the gut and other non-cancerous tissues, but he'll sort through all of that with you."

Granted, the odds are probably 'long' in my case, but I'll definitely be asking my RO about it here at 1:00 pm.

jim18 | @jim18 | Sep 10 1:28pm

SV and prostate bed are locally advanced vs. metastatic.

lagnafinc | @lagnafinc | Sep 10 2:10pm

All you can do is give them the info and the link.....my own RO was not familiar with that study. It's one of those things that might not be provable either way short of a biopsy of the SV: cancer or just radioactive urine. But we all know doctors tend to be conservative; and mine even after the article believed it was safer to assume cancer and be wrong, rather than assume simply radioactive urine....and be wrong. Hard to blame him.

The TUIP/TURP thing is related because those two procedures cut through all kinds of little veins, and what's left afterwards is a bit of a mini-plumbing mess which apparently can lead to SVUR. Anyway, you're now armed with a bit more info to at least ask your doctor about. In the end it is always up to us to decide what risks we will, or will not, take with our own health. Good luck !!

Here's yet another link to a separate study. It appears this topic is drawing attention from the diagnostic community. https://espace.library.uq.edu.au/view/UQ:f187e69

lagnafinc | @lagnafinc | Sep 10 2:16pm

Well you're right about that....however, the SV has its own clear path to the lymphatic system, so while my "fried" prostate might not wander there, the SV still can. That's the real concern...