Vesiculite seminal em garanhões: diagnóstico, evolução e tratamento com substância cauterizante
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Data
2019-02-08
Autores
Scheeren, Verônica Flores da Cunha
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Universidade Estadual Paulista (Unesp)
Resumo
Os garanhões possuem um conjunto completo de glândulas sexuais acessórias, compostas pelas bulbouretrais, a próstata, vesículas seminais e ampolas dos ductos deferentes. Dentre as afecções que acometem essas estruturas, a vesiculite seminal é a de maior ocorrência, consistindo na colonização de uma ou ambas as vesículas por bactérias, sendo a Pseudomonas aeruginosa a mais frequente. No ejaculado é observada uma grande percentagem de neutrófilos e hemácias podem estar presentes, caracterizando os quadros de piospermia e hemospermia, respectivamente. O diagnóstico definitivo é realizado por meio da endoscopia das vesículas, onde é possível visualizar o conteúdo purulento, associado à cultura bacteriana do lavado da glândula. O tratamento é desafiador, pois a antibioticoterapia apresenta baixa eficácia. Visto a importância desta enfermidade e a dificuldade do tratamento, este estudo teve como objetivo abordar os principais aspectos e avaliar a eficácia do ácido metacresolsulfônico e formaldeído para o tratamento da vesiculite seminal em garanhões, considerando os parâmetros seminais e características histopatológicas das vesículas seminais. Três garanhões adultos (n=3), com aspectos reprodutivos normais, tiveram a vesiculite seminal induzida por Pseudomonas aeruginosa através da endoscopia. Após 8 semanas de infecção, foi realizado tratamento local utilizando solução a 30% do ácido metacresolsulfônico e formaldeído (Lotagen®). O experimento consistiu em avaliações semanais, antes e após infecção experimental e após tratamento. Foram avaliadas as características do sêmen e das vesículas seminais, e cultura bacteriana do ejaculado e lavado vesicular. Alterações na coloração do sêmen foram observadas (3/3), enquanto que volume do ejaculado, concentração e motilidade espermática apresentaram variações fisiológicas (2/3), com redução no percentual de neutrófilos no sêmen e oscilações na integridade de membrana plasmática e acrossomal (3/3). A cultura bacteriana do sêmen após tratamento foi negativa (2/3), e um garanhão apresentou cultura positiva para Streptococcus equi subsp zooepidemicus, que desenvolveu epididimite bilateral. A ultrassonografia das vesículas mostrou variações no tamanho, quantidade e característica do conteúdo, com valores dentro da normalidade. Na endoscopia após infecção, as vesículas continham conteúdo purulento e posteriormente ao tratamento verificou-se a oclusão parcial das glândulas (2/3) e a mucosa mostrou-se fibrosada (1/3). As vesículas sadias apresentaram epitélio colunar simples, que após a infecção sofreu atrofia associado a intenso infiltrado inflamatório(3/3). Após 4 semanas do tratamento, observou-se um estroma fibromuscular com discreta inflamação (2/3) e displasia epitelial com infiltrado inflamatório misto (1/3). A cultura do lavado vesicular foi negativo após tratamento (3/3). A solução com ácido metacresolsulfônico e formaldeído à 30% foi eficaz para o tratamento da vesiculite seminal em garanhões, evitando o crescimento bacteriano de P.aeruginosa, diminuindo a porcentagem de neutrófilos no ejaculado e mantendo a qualidade seminal dos garanhões (2/3).
Stallions have a complete set of accessory sex glands, composed of the bulbourethral, prostate gland, seminal vesicles and ampullae. Among the diseases that affect these structures, seminal vesiculitis is the most frequent, consisting the colonization of one or both vesicles by bacteria, whose Pseudomonas aeruginosa is the most frequent. In ejaculate is observed a large percentage of neutrophils and erythrocytes may be present, characterizing piospermia and hemospermia, respectively. The definitive diagnosis is made through the endoscopical evaluation of the seminal vesicles, where it is possible to visualize the purulent contents, associated to gland lavage and bacterial culture. Treatment is challenging because antibiotic therapy is ineffective. Considering the importance of this disease and the difficulty of treatment, this study aims to address the most important aspects and evaluate the efficacy of metacresolsulfonic acid and formaldehyde for the treatment of vesiculitis in stallions, considering seminal parameters and histopathological characteristics. Three adult stallions (n = 3), with normal reproductive aspects, had seminal vesiculitis induced by Pseudomonas aeruginosa through endoscopy. After 8 weeks of infection, local treatment was performed using 30% solution of metacresolsulfonic acid and formaldehyde (Lotagen®). The experiment consisted of weekly evaluations, before and after experimental infection and after treatment. The characteristics of semen and seminal vesicles, and bacterial culture of ejaculate and vesicular lavage were evaluated. Changes in semen color were observed (3/3), while ejaculate volume, concentration and sperm motility presented physiological variations (2/3), with reduction in the percentage of neutrophils in the semen and oscillations in plasma and acrosomal membrane integrity (3/3). The bacterial culture of semen after treatment was negative (2/3), and a stallion presented a positive culture for Streptococcus equi subsp zooepidemicus, which developed bilateral epididymitis. Ultrasonography of the vesicles showed variations in the size, quantity and characteristic of the contents, with values within normality. In endoscopy after infection, the vesicles contained purulent contents and after treatment the partial occlusion of the glands (2/3) was verified and the mucosa was fibrosed (1/3). The healthy vesicles presented simple columnar epithelium, which after the infection suffered atrophy associated with intense inflammatory infiltrate (3/3). After 4 weeks of treatment, a fibromuscular stroma with mild inflammation (2/3) and epithelial dysplasia with mixed inflammatory infiltrate (1/3) was observed. Vesicular lavage culture was negative after treatment (3/3). The solution with 30% of metacresolsulfonic and formaldehyde was effective for the treatment of seminal vesiculitis in stallions, avoiding the bacterial growth of P.aeruginosa, reducing the percentage of neutrophils in the ejaculate and maintaining the seminal quality of stallions (2/3).
Stallions have a complete set of accessory sex glands, composed of the bulbourethral, prostate gland, seminal vesicles and ampullae. Among the diseases that affect these structures, seminal vesiculitis is the most frequent, consisting the colonization of one or both vesicles by bacteria, whose Pseudomonas aeruginosa is the most frequent. In ejaculate is observed a large percentage of neutrophils and erythrocytes may be present, characterizing piospermia and hemospermia, respectively. The definitive diagnosis is made through the endoscopical evaluation of the seminal vesicles, where it is possible to visualize the purulent contents, associated to gland lavage and bacterial culture. Treatment is challenging because antibiotic therapy is ineffective. Considering the importance of this disease and the difficulty of treatment, this study aims to address the most important aspects and evaluate the efficacy of metacresolsulfonic acid and formaldehyde for the treatment of vesiculitis in stallions, considering seminal parameters and histopathological characteristics. Three adult stallions (n = 3), with normal reproductive aspects, had seminal vesiculitis induced by Pseudomonas aeruginosa through endoscopy. After 8 weeks of infection, local treatment was performed using 30% solution of metacresolsulfonic acid and formaldehyde (Lotagen®). The experiment consisted of weekly evaluations, before and after experimental infection and after treatment. The characteristics of semen and seminal vesicles, and bacterial culture of ejaculate and vesicular lavage were evaluated. Changes in semen color were observed (3/3), while ejaculate volume, concentration and sperm motility presented physiological variations (2/3), with reduction in the percentage of neutrophils in the semen and oscillations in plasma and acrosomal membrane integrity (3/3). The bacterial culture of semen after treatment was negative (2/3), and a stallion presented a positive culture for Streptococcus equi subsp zooepidemicus, which developed bilateral epididymitis. Ultrasonography of the vesicles showed variations in the size, quantity and characteristic of the contents, with values within normality. In endoscopy after infection, the vesicles contained purulent contents and after treatment the partial occlusion of the glands (2/3) was verified and the mucosa was fibrosed (1/3). The healthy vesicles presented simple columnar epithelium, which after the infection suffered atrophy associated with intense inflammatory infiltrate (3/3). After 4 weeks of treatment, a fibromuscular stroma with mild inflammation (2/3) and epithelial dysplasia with mixed inflammatory infiltrate (1/3) was observed. Vesicular lavage culture was negative after treatment (3/3). The solution with 30% of metacresolsulfonic and formaldehyde was effective for the treatment of seminal vesiculitis in stallions, avoiding the bacterial growth of P.aeruginosa, reducing the percentage of neutrophils in the ejaculate and maintaining the seminal quality of stallions (2/3).
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Palavras-chave
Equino, Garanhão, Glândula sexual acessória, Lotagen®, Vesícula seminal, Accessory sex gland, Equine, Lotagen®, Seminal vesicle, Stallion