A prospective study on aetiology and outcome of haemospermia from a urology unit in Sri Lanka

Sivanandan, Sopan; Wijayarathna, Suranga; Balagobi, B.; Kumara, M. G. S. R.; Ambegoda, Madura; Abeygunasekera, Anuruddha M

doi:10.1177/2051415819836021

Cited by 4 publications

(5 citation statements)

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“…[8] A Sri Lankan study comprising 94 patients reported a clinical diagnosis of prostatitis as the commonest diagnosis in 29% with a prostate cancer detection rate of only 1.1%. [3] In our series, the overall prostate cancer detection rate was 5.3% in the overall cohort and a detection rate of 7.2% in the ≥40 years group. One patient had a finding of an incidental 8 mm testicular lesion found to be a seminoma detected in a patient under 40 years.…”

Section: Literature Reviewmentioning

confidence: 43%

“…A Sri Lankan study comprising 94 patients reported a clinical diagnosis of prostatitis as the commonest diagnosis in 29% with a prostate cancer detection rate of only 1.1%. [3]…”

Section: Discussionmentioning

confidence: 99%

“…The latter however was conducted in a prostate cancer screening group in those who reported hematospermia. [2,3] The aim of this study was to retrospectively review all patients presenting with hematospermia to a tertiary specialist center to report the diagnostic yield of all the investigations undertaken and the incidence of underlying pathology. Investigations were requested according to individual clinician preferences and therefore are a reflection of the varied practice of urologists investigating the condition.…”

Section: Introductionmentioning

confidence: 99%

“…The latter however was conducted in a prostate cancer screening group in those who reported hematospermia. [2,3]…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Detection rates of urogenital cancers and benign pathology in men presenting with hematospermia

Satchi¹,

Katelaris²,

Smékal³

et al. 2022

Current Urology

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Background: Hematospermia, although often found to be a benign condition, can be an alarming sign. Consequently, patients can undergo multiple investigations with no current standardized pathway based on data from large series. The aim of this study was to evaluate the incidence of an underlying pathology and the value of diagnostic investigations performed in patients presenting with hematospermia. Materials and methods: A retrospective review of 393 consecutive men who underwent investigations for hematospermia was performed in a single tertiary center. Patient demographics, radiological and microbiological results were recorded together with symptoms of concomitant hematuria and clinical outcomes. Results: In this cohort, the overall prostate cancer detection rate was 5.3% and 7.2% in the ≥40 years group. One patient was diagnosed with testicular seminoma detected on scrotal ultrasound scan and one with G1pTa urothelial carcinoma of the bladder detected on flexible cystoscopy. In addition, 5.6% of patients were found to have a significant benign pathology for which intervention was proposed. A total of 288 patients underwent a transrectal ultrasound scan and 58.7% (n = 169) of these patients were found to have a positive finding. One hundred ten patients underwent a multiparametric magnetic resonance imaging and 73.6% (n = 81) had a positive finding. Conclusions: Apart from transrectal ultrasound and multiparametric magnetic resonance imaging, the remaining investigations have a low diagnostic yield. Prostate cancer detection was 5.3%; 7.2% in the ≥40 years group, and two further patients were diagnosed with testicular and bladder malignancy. Based on our results, we propose an algorithm for the management of hematospermia to limit unnecessary investigations with the majority requiring reassurance.

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Section: Literature Reviewmentioning

confidence: 43%

“…A Sri Lankan study comprising 94 patients reported a clinical diagnosis of prostatitis as the commonest diagnosis in 29% with a prostate cancer detection rate of only 1.1%. [3]…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The latter however was conducted in a prostate cancer screening group in those who reported hematospermia. [2,3]…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Detection rates of urogenital cancers and benign pathology in men presenting with hematospermia

Satchi¹,

Katelaris²,

Smékal³

et al. 2022

Current Urology

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“…By knowing the anatomy and function of the ejaculatory apparatus, we can suspect the source of hematospermia to be from any part of this apparatus like the prostate gland, seminal vesicles, epididymis, ejaculatory ducts, and urethra [3,4,5]. October 2023 ,Volume 25, Issue 1 On the other hand, hematospermia could result from bleeding tendency disorders just like bleeding from other sites like hematuria or gastro-intestinal bleeding that can be caused by systemic diseases or bleeding tendency that may be due to coagulative disease or drugs like anticoagulants [6,7,8].…”

Section: Discussionmentioning

confidence: 99%

Etiology and outcome of hematospermia :A prospective study

Karim Hadaia

2023

djm

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Background: Although hematospermia is not common but considered an alarming symptom for patient and doctor. The cause of this worry is that it has been described as a dangerous symptom of prostate cancer by the patients and the health workers. Objective: To classify the causes and outcome of hematospermia. Patients and Methods: : This is a prospective study of patients newly diagnosed with hematospermia-diagnosed and treated in private clinic and hospital over a period of 4 years (2018-2022). Data collection and recording done related to demographic, symptomatology, clinical finding, investigations, treatment given and the outcome during 6 months of follow up. Results: One hundred and six patients with hematospermia were seen in the private clinic and hospital. The mean age was 40 years (25-70). Thirty-six (33.9%) patients were diagnosed as prostatitis clinically or by positive seminal fluid culture. Only (4) patients had prostate carcinoma with only one new case and the other three were known cases of prostate cancer already on treatment. With (4) cases had thrombocytopenia and (2) cases with sickle cell anemia and (1) case each prostate cyst and severe hypertension and vesical stone. (2) cases on anticoagulant therapy. And another (2) cases with history of epididymal surgery. There was no identifiable cause in the remaining 53 patients (50%). Conclusion: the majority of patients presented with hematospermia were below 50 years and have benign etiology and most of them were self-limited and less than 1% of cases revealed new prostate cancer. So, we can confidently reassure a patient presented with hematospermia due to benign nature of the disease in the majority of patients, especially in young patients.

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Hematospermia Etiology, Diagnosis, Treatment, and Sexual Ramifications: A Narrative Review

Drury

King

Herzog

2022

Sexual Medicine Reviews

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Introduction Hematospermia (HS) is the presence of blood in ejaculatory fluid. It is a rare condition that is historically idiopathic or associated with sexual behavior. Technological advances have identified many of the etiologies behind HS, improving treatment. Though often benign, HS remains a source of considerable sexual anxiety for patients. Few papers have outlined a diagnostic and therapeutic approach to HS, and none have explicitly addressed its sexual consequences. Objectives To provide a comprehensive overview of HS, emphasizing its sexual ramifications. Methods A PubMed literature search was performed through May 2021 to identify all relevant publications related to etiology, diagnosis, treatment, and sexual effects of HS. Original research and reviews were analyzed, and pertinent studies were included in this review. Results Iatrogenic interventions (eg, transrectal ultrasound-guided prostate biopsies) are the most common cause of HS. Infection and/or nonspecific inflammation is the most common non-iatrogenic etiology. Malignancies, including prostate, testicular, and other genitourinary cancers, are rarely the cause of HS. Diagnostic approaches to HS can be organized according to patient age (less than or greater than 40 years old), persistence of bleeding, and the presence/absence of concerning symptoms. Though HS often spontaneously resolves, treatment may require various medications (eg, antibiotics, anti-inflammatories) or surgical interventions. HS has several sexual ramifications, including libido-affecting anxiety, social repercussions from sexual partners and non-sexual affiliates, increased risk of erectile dysfunction or transmission of sexual infections, and compromised fertility, especially when cryopreservation is utilized. Conclusion HS may significantly affect sexual health through several mechanisms, though there is a paucity of formal data on this subject. Further research is needed to fully understand the severity and extent of HS's effect on sexual well-being, especially in those with refractory bleeding.

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A prospective study on aetiology and outcome of haemospermia from a urology unit in Sri Lanka

Cited by 4 publications

References 13 publications

Detection rates of urogenital cancers and benign pathology in men presenting with hematospermia

Detection rates of urogenital cancers and benign pathology in men presenting with hematospermia

Etiology and outcome of hematospermia :A prospective study

Hematospermia Etiology, Diagnosis, Treatment, and Sexual Ramifications: A Narrative Review

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