The Seminal Vesicles

MEDICAL LIBRARY i- Cl0 0002 2426 - ' ' --- 111 ,I II 111111111111111 ?''-. THE SEMINAL V E S I C L E S ,,_#:;(" l ANATOTulY, COMP ARAT:i'.VE ANATOMY AND DEVELOPMENT . Town BY P.J. MITFORD RETIEF;Cape M.B. Ch.B. (Cape Town) of • I ' I -~ University This thesis is submitted as a part of the requirements for the Master of Surgery Degree at the Cape Town Univer sity. September, 1945. Town The copyright of this thesis vests in the author. No quotation from it or information Capederived from it is to be published without full acknowledgement of the source. The thesis is to be used offor private study or non- commercial research purposes only. Published by the University of Cape Town (UCT) in terms of the non-exclusiveUniversity license granted to UCT by the author. ,. t~ ~'.. i I N D E X • Pages. INTRODUCTION . 1 2 ·( HISTORICAL REVIEW . .. .. 2a - 2d ANATOMY . 3 65 EMBRYOLOGICA;L DEVELOPJ\/IENT . 66 81 "'· COMPARATIVE ANATOMY . 82 - 130 }~' ,,, C 0 NC L u s I 0 N . .. 130 BIBLIOGRAPHY . 131 '- 136 J) - J 1 ( ' \ \ INTRODUCTION • • There are many reasons which induced me to choose this subject for a thesis. I would like to mention only the most important one. Between 1942 and 1945, while in the South ( African Medical Corps, I was posted to the Wynberg Military Hospital. During this time I was closely associated with the urological service of the hospital. It struck me very forcibly how many soldiers were off duty on account of a genito-urinary complaint. In the majority of these the diagnosis was prostato vesicuJ.1tis; and it must be stressed, as it has been done by many others, that an infection with the gonococcus was the exciting cause in no more than one half the number of cases. I formed the opinion that more soldiers were off duty on account of prostato- . vesictilltis than for any other single disease. Quite a number of them remained the best part of a year in hospital. I had the good fortune to become well- acquainted with this clinical entity. The diagnosis, ')11 -~'I· management and treatment of these cases requires patience and expert ~\raining. Except in the mildest cases the treatment is very protracted. In some of them the con- dition remains baffling and the results are disappoint ing. Signs and symptoms may be referred to nearly all parts of the body, and severe neurasthenia is the in evitable result, unless the focus of disease is - adequately - 2 adequately dealt with. ' It has been suggested by numerous authorities that most of the trouble in prostato-vesicuJ.1 ti.s, emanates from the infection in the seminal vesicle; that in fact the vesiculitis forms the basis of what has for many years been called 11 prostatic rheumat1sm 11 • I To this purpose then, I determined to find out what I could about the seminal vesicles. It seemed essential to me that a good knowledge of the structure and function of these glands must preceed· any serious attempt to understand its pathology. The material available for this study came from various sources. I used twelve cadavers whose ages ranged between 8 years and 70 years. When the the I: students in/anatomy dissection room had completed that part, I removed the seminal vesicles from their 16 cadavers. I collected 12 foetuses of various ages. I recovered the bladder, rectum and accessory-glands from 15 autopsy cases. I attended 6 official judicial hangings and these six cases offered an exceptionally good opportunity to study the structure and function of these glands. In all there were then 61 specimens. Only six of these were from Europeans, the rest being mainly natives. The subject will be discussed under the following chapters:- (1) BRIEF HISTORICAL REVIEW. (2) ANATOMY. (3) EMBRYOLOGICAL DEVELOPMENT. (4) COMPARATIVE ANATOMY. 2a HISTORICAL REVIEW OF THE ACCESSORY GENITAL. GLANDS. There is but scant reference made to the accessory genital glands in medical history. Only one pair is associated with a personal ,name, viz: Cowper's glands. The fact that "Ines~ are small and hidden in the muscular meshes of the urogenital diaphragm,accounts for this. Anatomical structures are as a rule associated with the names of their dis coverers only when their de.script ion and recognition is rela- tively recent. The ancient anatomists often overlooked structures which in later days were recognised because of their functional importance and by superior methods of inves- • any tigation. This in no way implieS,hdiscredit to those early pioneers, but for whom there would have been no basis on which to work. On the contrary one is amazed at the accuracy and the detail which they provided, when one bears in mind the difficulties they had. These men were often taken to the stake for expressing views based on direct observation • when such views were at variance with the accepted teachings, and especially those of the Church. We must take it though that the earliest anatomists described the genital system and the accessory glands. There is no proof to the contrary; certain it is that from earliest days there was sufficient interest taken in the genital system. Hippocrates, who lived three centuries before Christ, makes reference to such matters. He was a very keen observer and a student of nature. His "Aphorisms" are classic; and to this day physicians speak of the"Facies Hippocratica", so typically seen in certain acute febrile diseases. I would like to quote his 28th and 30th paragraphs in Section rv of his Aphorisms:- "Eunuchs do not take gout, nor become bald" "A young man does not take gout, until he takes coition". These quotations - .. 2b These quotations have a large measure of truth in the light of our present day knowledge. "Prostatic rheumatism" is a well known clinical entity, and many authorities main tain that the majority of prostatic infections follow venereal infection. Certain it is that infections in either the prostate or the seminal vesicles are often associated with very marked and painful joint lesions. In the time of Hippocrates all such afflictions were probably cal led gout. Rippocra~es never had the privilege of doing human dissection. He, and another profound thinker of a century later, the celebrated Aristotle, inferred their human anatomy from animal anatomy. Aristotle also wrote the first book on Embryology, and based his work on observations of the developing chick embryo. His work was not improved upon for 2000 years ! It was for the school at Alexandria to lay the foundation stones of human anatomy. Here in the third century B.C. Erasistratus and Herophilus did human dissections. Their original writings are lost, and we only have references of their work from later scientists, notably Galen (130-201 A.D.) This voluminous writer influenced the··· scientific and medical mind for many centuries. During the bleak period of the Dark Ages, medicine was kept alive by the Arabians, and with the Renaissance in Europe came daring men who challenged Galen's fictitious postulates and placed anatomy and all scientific investigations on a sound basis once more. It now became necessary to see before one believed. Outstanding amongst these earliest anatomists are the names of Mondino de Lucci; (1275 - 1326), Leonardo da Vinci; (1452 - 1519), and Andreas Vesalius; (1514 - 1564) They drew up the first anatomy text books; and basing their work on direct observation at dissections of the human body, it is 2c - it is quite certain that the accessory genital glands were l' described. Names for anatomic structure were in Latin and I; given to describe the position or supposed function. In this way the prostate (prostata) was so called probably because it lay partly in front of the urethra a typically human state of affairs,and found in no other pri- mates and very seldom in other animals. It is also claimed that the name arises from the fact that the prostate lies in front of the seminal vesicles. The "vesica seminalis" desig- ' nated that the function of these paired organs was as a reservoir for semen. A flood of controversy has descended on this concept and will be fully discussed later. The bulbo-urethral glands were described by Wi~liam Cowper in 1699. Actually these were independently described in France by Mery in 1685. These glands are called Cowper's glands in common international usage. Such mistakes in priority of nomenclature are a very common occurrence in medicine. There are other glands which can be classed as accessory to the genital tract. They are para-urethral glands, and associated with the names of Littre and Albarran. These will be considered in more detail in a later chapter. Finally it will be fitting to mention a few histori cal facts about the spermatozoa, which are the ultimate essen tial elements in the male share of reproduction.- The general function of the prostate, seminal vesicles and other sex glands is directed in the well-being of the spermatozoa. 'In 1677,-Ham, a student of the celebrated Van Leeuwenhoek, for the first time saw and described human sper- rnatozoa. They were regarded as tiny animals because of their active movement. Their name indicates this idea and was coined by Von Baer, who also laid the foundations of modern Embryology. It was only in 1841 that Knlliker·demonstrated that these '~animalsn, were nothing of the sort and arose by a process of 2d - ' • process of spermatogenesis in the testes. Meanwhile the mammalian ovum had. been recognised (1827), but it was not until 1875 that Oskar Hertwig proved that re production followed a process of fertilization of the ovum by one spermatozoon.

Load more