Seminal vesicle calculi are typically brown in color and may comprise inspissated protein or contain a mucoepithelial core covered with stone forming components such as calcium carbonate, urates, and phosphate (Fig. 1) (22). Men typically present with hematospermia, hematuria, painful ejaculation (23), pain, or as an incidental finding (22). Reflux of urine into the seminal vesicle, obstruction, infection, or congential anomalies have all been described as predisposing factors. Intervention is only necessary if symptoms warrant it, the pain is lateralizing, and imaging with computed tomography or magnetic resonance imaging indicates a stone. If composed only of inspissated protein seminal vesicle stones will not be visible on a computed tomography scan, and a T2-weighted magnetic resonance imaging with coronal imaging is recommended (Fig. 2) (22).

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