Hematospermia: imaging findings

Torigian, Drew A.; Ramchandani, Parvati

doi:10.1007/s00261-006-9130-z

Cited by 11 publications

(23 citation statements)

References 168 publications

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“…It was located in the midline region on MRI imaging and was usually confined to the prostate boundary within which signals were generally long T1 and T2 signals. Prostatic utricle cysts and the urethra are interlinked (Torigian & Ramchandani, ), with occasional single‐sided or double‐sided abnormal openings of the ED within the cyst. If this is the case, the cyst can appear to be bleeding and the abnormal signal intensity change in the prostatic utricle cysts will be similar to that found with bleeding from the unilateral or bilateral SV.…”

Section: Discussionmentioning

confidence: 99%

“…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, ). Previous reports have shown that the majority of haematospermia cases are idiopathic and that the most probable site of origin is the seminal vesicles (SV) (Yagci et al ., ; Furuya & Kato, ).…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

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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“…The patient will usually pre sent with lower urinary tract symptoms due to mass effect on the bladder base, associated trabeculae, diverticula formation, and diffuse bladder wall thickening due to obstruction. BPH is uncommon below the age of 40 years, but the incidence increases by 10% per decade and reaches 80% by age 80 (2). Chronic inflammation is believed to support the process of fibromuscular growth in BPH, resulting in a significantly enlarged prostate, high PSA level, and greater risk of acute urinary retention (61).…”

Section: Bphmentioning

confidence: 99%

“…Hematospermia is defined as frank blood in the ejaculate. It is a wellrecognized clinical condition in young adults and often attributed to sexual behaviors such as prolonged abstinence and interrupted coitus (1,2). Clinical distinction between hematospermia and hematuria is essential as they may coexist in some cases.…”

Section: Introductionmentioning

confidence: 99%

Hematospermia Evaluation at MR Imaging

Mittal¹,

Camacho²,

Sahani

et al. 2016

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Hematospermia is a challenging and anxiety-provoking condition that can manifest as a single episode or recur over the course of weeks to months. It is usually a benign self-limiting condition in younger sexually active males without a history of risk factors such as cancer, urogenital malformations, bleeding disorders, and their associated symptoms. However, patients with recurrent, refractory and painful hematospermia with associated symptoms, such as fever, pain, or weight loss, require evaluation through clinical assessment and noninvasive investigations to rule out underlying pathologic conditions such as ejaculatory obstruction, infectious and inflammatory causes, malignancy, vascular malformations, and systemic disorders that increase the risk of bleeding, especially when presenting in older men. If these investigations are negative, the patient should be reassured and treated accordingly. In the recent past, magnetic resonance (MR) imaging has assumed a major role in the investigation of hematospermia due to its excellent soft-tissue contrast and multiplanar capabilities. In this review, we will discuss the potential causes of hematospermia and its diagnostic workup, including pathophysiology, anatomic considerations, the imaging appearance of associated pathologic conditions, and management. (©)RSNA, 2016.

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“…HS may be associated with pathology in the prostate gland, seminal tract (seminal vesicles, vasa deferentia, and ejaculatory ducts), verumontanum, urethra, urinary bladder, epididymis, or testes, with cited causes reported to include prior prostatic biopsy, prostatic calculi, inflammatory or infectious conditions such as prostatitis or seminal vesiculitis, ductal obstruction, prostatic cyst formation, and rarely vascular malformations. The majority of cases of HS were thought to be idiopathic in nature; however, as a result of improved imaging techniques, the number of cases labeled as idiopathic has decreased significantly, with one of the main sites of bleeding occurring in the seminal vesicles [1][2][3][4][5][6][7][8][9][10][11][12][13]. Of specific etiologies, infectious or inflammatory conditions are the most common, accounting for approximately 40% of HS cases overall.…”

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confidence: 99%

ACR Appropriateness Criteria ® Hematospermia

Hosseinzadeh

Oto

Allen

et al. 2017

Journal of the American College of Radiology

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Most men with hematospermia or hemospermia (HS) are young (<40 years of age), presenting with transient or episodic HS without other signs or symptoms of disease. The condition is self-limiting in most cases and idiopathic in nature. When a cause can be identified, infections of the urogenital tract are the most common. Imaging does not play a role in this patient population. In older men (>40 years of age), clinical screening for prostate cancer is advised. Furthermore, when HS is persistent or has symptoms, causes include obstruction or stricture at the level of the verumontanum, calcifications or calculi in the prostate, ejaculatory ducts or seminal vesicles, and cysts arising within these structures. Noninvasive imaging, predominantly transrectal ultrasound (TRUS) and MRI, can be used in men of any age with persistent or refractory HS, or other associated symptoms or signs. TRUS is considered as the first-line imaging with MRI used when TRUS is inconclusive or negative. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer-reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

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Hematospermia: imaging findings

Cited by 11 publications

References 168 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

Hematospermia Evaluation at MR Imaging

ACR Appropriateness Criteria ® Hematospermia

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