Hematospermia: etiological and management considerations

Leocádio, Dean E.; Stein, Barry S.

doi:10.1007/s11255-008-9409-9

Cited by 41 publications

(44 citation statements)

References 30 publications

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“…Haematospermia is a common symptom in the fields of urology and andrology that mainly occurs in people <40 years of age (Kumar et al ., ), however, the exact prevalence and incidence are not known (Mulhall & Albertsen, ). Haematospermia can last from a few weeks to several years, although it is generally painless, benign and self‐limiting (Leocadio & Stein, ). The most common issues that have been reported in men with haematospermia include prior prostatic biopsy, prostatic calculi, benign prostatic hypertrophy and inflammation or infections, such as chronic prostatitis or seminal vesiculitis (Torigian & Ramchandani, ).…”

Section: Introductionmentioning

confidence: 99%

Clinical analysis of the characterization of magnetic resonance imaging in 102 cases of refractory haematospermia

Zhang

et al. 2013

Andrology

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SUMMARYTo analyze the pathogenesis of persistent and refractory haematospermia and to evaluate the aetiological diagnostic value of magnetic resonance imaging (MRI) for this type of haematospermia. Clinical data from 102 patients with persistent and refractory haematospermia was retrospectively analysed. Data collected included history, symptoms, as well as ultrasound and MRI of the morphological features of the bilateral seminal vesicles (SV) and ejaculatory duct (ED) areas. Criteria for inclusion were haematospermia symptoms that occurred more than six times, that lasted more than 6 months, and that did not improve after >1 month of conservative treatment. Patients underwent seminal vesiculoscopy with a post-surgery follow-up of 3-48 months [average (18.1 AE 10.3) months]. Of the 102 patients that underwent MRI examination, data from 88 patients (86.3%) showed typical and characteristic changes in the ED area, including the signal intensity changes in 60 (58.8%), SV volume changes in 32(31.4%), the formation of cysts such as prostatic utricular cysts in 27 (26.5%), M€ ullerian cysts in 4 (3.9%), ED cysts in 5 (4.9%) and a SV cyst in 1(1.0%). The MRI findings were confirmed by seminal vesiculoscopy and all patients received appropriate treatment. In 14 patients (13.7%), no obvious abnormal changes were observed with MRIs, however, these patients were diagnosed and successfully managed using seminal vesiculoscopy. Some degrees of ED obstruction was usually found during surgery. The symptoms of haematospermia disappeared 1-2 months after surgery in all patients. Two patients had a recurrence of haematospermia, underwent the same treatment, and recovered during the follow-up period. The aetiology of the most cases of the refractory haematospermia can be distinguished using the three-dimensional MRI. Typical abnormalities observed on MR images are signal intensity, SV volume changes and cyst formation. MRI has significant etiological diagnostic value and provides reliable information for the subsequent treatment of patients with persistent and refractory haematospermia.

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Section: Introductionmentioning

confidence: 99%

Clinical analysis of the characterization of magnetic resonance imaging in 102 cases of refractory haematospermia

Zhang

et al. 2013

Andrology

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“…1 Pelvis X-ray can supply an initial evaluation of the genitourinary tract, as transrectal ultrasound can demonstrate the relative anatomy of the prostate and seminal vesicle without radiation exposure. 4 When the above examination cannot offer definite findings of the prostate or seminal vesicle area, pelvic computed tomography and magnetic resonance imaging are the image examinations of choice. 5 Magnetic resonance imaging is sometimes preferred, owing to its detailed demonstration of the anatomic structure and inner lesion of the prostate and seminal vesicle.…”

Section: Discussionmentioning

confidence: 99%

Successful seminal vesiculoscopic lithotripsy of seminal vesicle stone: A case report and literature review

et al. 2014

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Keywords: hematospermia seminal vesicle stone seminal vesiculoscopic lithotripsy a b s t r a c t Seminal vesicle stones are rare; the first case was reported in 1928. We present a case of 51-year-old male with bloody semen and perineal discomfort for several years. He received seminal vesiculoscopic lithotripsy successfully; his recovery and improvement of symptoms were satisfactory. Diagnosis depends on an initial pelvis X-ray, sonography, and further computed tomography/magnetic resonance imaging if necessary. Traditional surgery is open seminal vesiculectomy. Seminal vesiculoscopic lithotripsy can be viewed as a new intervention of choice.

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“…However, onward referral criteria are based on expert opinion, supported by limited evidence. [3][4][5][6] The algorithm ( fig 1⇓) showing the initial assessment and management of haematospermia is based on authors' clinical experience and practice.…”

Section: What You Should Domentioning

confidence: 99%

“…3 8 Prostate cancer presents with isolated haematospermia between 3.7% and 13.7% of the time. [4][5][6][7][8][9][10] Raised concentrations of prostate specific antigen and an abnormal digital rectal examination with haematospermia increase these chances. 4 Provenance and peer review: Commissioned and externally peer reviewed.…”

Section: Box 2: Advice For Men Experiencing Haematospermiamentioning

confidence: 99%

Haematospermia

Drake

Hanna

Davies

2016

BMJ

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A 40 year old man complains of two episodes when he noticed blood in his ejaculate. He is otherwise well and has no comorbidities.Visible blood in ejaculate-haematospermia or haemospermia-is usually an isolated symptom, and its incidence is unknown. In most cases, it is benign and self limiting, often caused by inflammation or infection of the prostate, urethra, or seminal tract. 1 Possible causes are outlined in Box 1. Patients may describe haematuria, urinary frequency, dysuria, and scrotal, pelvic, or perineal pain, particularly at the time of orgasm. 2 What you should cover HistoryAsk about:• Timing, frequency, and duration of haematospermia, and colour of the semen: bright red with or without clots (that is, fresh bleeding), or brown (old blood).• Associated urinary symptoms suggestive of infection-for example, dysuria, frequency, or urgency of urination, visible haematuria, pain in the abdomen, scrotum, pelvis, or perineum.• Sexual history, including presence of urethral discharge, which could point to a sexually transmitted infection. • Recent urological investigation or intervention.• History of prolonged or excessive bleeding or easy bruising from minor injuries or surgical procedures suggestive of bleeding disorders or a history of coagulopathy.• Travel history, particularly to areas where tuberculosis and schistosomiasis are endemic, as these can cause genitourinary tract infections.• Family history of prostate cancer, particularly in first degree relatives and relatives diagnosed under the age of 60, and coagulopathies. Examination• Ask the patient to expose the external genitalia. Palpate for any lumps, scrotal tenderness, or swelling, which could indicate underlying testicular or epididymal pathology• Perform a digital rectal examination to detect prostatic enlargement, tenderness, fluctuance, firmness, or nodules• Look for signs of easy bruising or bleeding tendencies, such as large bruises (>5 cm in diameter) in the absence of trauma, and petechiae• Examine the abdomen for hepatosplenomegaly, which could indicate an underlying haematological, liver, or infectious disease• Measure blood pressure to identify uncontrolled hypertension What you should doHaematospermia can cause alarm. Reassure patients that a single episode is likely to be benign and self limiting, and ask them to return if the problem continues (Box 2).The initial approach is to rule out infectious causes (Box 1). We suggest that these results are interpreted based on the age of the patient. However, onward referral criteria are based on expert opinion, supported by limited evidence. 3-6 The algorithm ( fig 1⇓) showing the initial assessment and management of haematospermia is based on authors' clinical experience and practice.In patients aged under 40, the most common cause is infection, and management can be guided by non-specialists. Urologists tend to recommend a prolonged course of antibiotics, usually six weeks in duration. Consider referral to a genitourinary medicine clinic if you suspect a sexually transmitted infection to ...

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Hematospermia: etiological and management considerations

Cited by 41 publications

References 30 publications

Clinical analysis of the characterization of magnetic resonance imaging in 102 cases of refractory haematospermia

Clinical analysis of the characterization of magnetic resonance imaging in 102 cases of refractory haematospermia

Successful seminal vesiculoscopic lithotripsy of seminal vesicle stone: A case report and literature review

Haematospermia

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