Clinical Significance of Transrectal Ultrasonography and Efficacy of Dutasteride Treatment in Patients with Hemospermia

Abstract

Purpose: The aims of this study were to investigate the clinical significance of transrectal ultrasonography (TRUS) and the efficacy of dutasteride (5α-reductase inhibitor) in patients with hemospermia. Materials and Methods: From January 2005 to December 2008, 60 patients with hemospermia were enrolled in the study. All patients underwent a digital rectal examination and TRUS; serum prostate specific antigen was also measured. The management of hemospermia was one of the following: watchful waiting, dutasteride treatment, or antibiotics with dutasteride. Results: Thirty-four patients (56.7%) had positive findings on TRUS. There were 16 cases (26.7%) of prostate calcification, 13 cases (21.7%) of ejaculatory duct cyst, 3 cases (5%) of ejaculatory duct calcification, a case of seminal vesicle inflammation, and a case of ejaculatory duct dilation. Dutasteride treatment resulted in improvement of symptoms in 87.9% (29/33) of the cases, whereas treatment with antibiotics or antibiotics with dutasteride resulted in a 100% (6/6) success rate. However, among 14 watchful waiting patients, only 3 patients (21.4%) showed an improvement of symptoms. Conclusions: This study showed that TRUS is an easy and effective method for the assessment of hemospermia, and also revealed that dutasteride could be a useful agent in the treatment of hemospermia.