Extra-renal manifestations of autosomal dominant polycystic kidney disease (ADPKD) have been known to involve male reproductive organs, including cysts in testis, epididymis, seminal vesicles, and prostate. The reported prevalence of seminal vesicle cysts in patients with ADPKD varies widely, from 6% by computed tomography (CT) to 21%–60% by transrectal ultrasonography. However, seminal vesicles in ADPKD that are dilated, with a diameter greater than 10 mm by magnetic resonance imaging (MRI), are “megavesicles”. This is a separate entity from seminal vesicle cysts and has a prevalence of 23% in ADPKD patients, but is not known to occur in patients without ADPKD. The basis of these cystic changes and megavesicles has not been established, but may be explained by an imbalance between cell growth/proliferation inhibitors and stimulators analogous to mechanisms in renal tubular epithelial cells, hepatic ducts, and in the vasculature. Male infertility has been associated with ADPKD, although a causal role of seminal tract abnormalities has not been established. In this chapter, the anatomic abnormalities of seminal vesicles in ADPKD and their clinical significance will be discussed.
