1
|
Suh Y, Gandhi J, Joshi G, Lee MY, Weissbart SJ, Smith NL, Joshi G, Khan SA. Etiologic classification, evaluation, and management of hematospermia. Transl Androl Urol 2017; 6:959-972. [PMID: 29184797 PMCID: PMC5673809 DOI: 10.21037/tau.2017.06.01] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Hematospermia is defined by the presence of blood in the semen typically occurring in men younger than 40 years of age. Symptoms can occur due to a multitude of reasons, but are usually benign and self-limiting, requiring no additional treatment or evaluation. Despite this, the condition often impairs quality of life due to associated anxiety and must be taken seriously by the patient and the physician, particularly if recurrent, refractory, and painful. The etiology of hematospermia can be classified into inflammatory, infectious, lithiasis, cystic, obstructive, tumoral, vascular, traumatic, iatrogenic, and systemic origin. Alternatively, it can also be divided into subcategories based on anatomical origins such as prostate, bladder, spermatic cord, seminal vesicles, or epididymis. A complete history and physician examination, laboratory testing, and a variety of invasive and non-invasive imaging and instrumentation modalities can help to identify and treat the underlying pathology promptly.
Collapse
Affiliation(s)
- Yiji Suh
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Jason Gandhi
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA.,Medical Student Research Institute, St. George's University School of Medicine, Grenada, West Indies
| | - Gunjan Joshi
- Department of Internal Medicine, Stony Brook Medicine at Southampton Hospital, Southampton, NY, USA
| | - Min Yea Lee
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Steven J Weissbart
- Department of Urology, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | | | - Gargi Joshi
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Sardar Ali Khan
- Department of Physiology and Biophysics, Stony Brook University School of Medicine, Stony Brook, NY, USA.,Department of Urology, Stony Brook University School of Medicine, Stony Brook, NY, USA
| |
Collapse
|
2
|
Wang LJ, Tsui KH, Wong YC, Huang ST, Chang PL. Arterial bleeding in patients with intractable hematospermia and concomitant hematuria: A preliminary report. Urology 2006; 68:938-41. [PMID: 17113883 DOI: 10.1016/j.urology.2006.06.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2006] [Revised: 05/09/2006] [Accepted: 06/06/2006] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To assess the presence of arterial bleeding and its outcome after transcatheter arterial embolization (TAE) in patients with intractable hematospermia and concomitant hematuria. METHODS In a 32-month period, 5 patients with hematospermia and concomitant hematuria who were unresponsive to medical treatment were enrolled in this study to undergo pelvic angiography. When angiography revealed arterial bleeding, TAE was done whenever possible to stop the bleeding. All patients were then followed up at the outpatient clinics by the referring urologists for the result of TAE on hematospermia and the presence of impotence. RESULTS Arterial bleeding mainly from the internal pudendal artery was revealed by angiography in all 5 patients. The cessation of bleeding by TAE was successfully achieved in all patients. Hematospermia was improved in 3 patients. In the other 2 patients, hematospermia subsided after TAE but recurred at 12 and 23 months. Subsequent angiography of the 2 patients showed recurrent arterial bleeding, fed by blood flow from the opposite side. One of the 2 patients agreed to undergo a second TAE, after which the hematospermia disappeared. None of the 5 patients had impotence at follow-up. CONCLUSIONS Patients with intractable hematospermia and concomitant hematuria may have arterial bleeding that can be detected by angiography. The cessation of the bleeding could be achieved by TAE without complication of impotence. However, long-term follow-up is necessary for possible reconstitution of blood flow from the opposite side.
Collapse
Affiliation(s)
- Li-Jen Wang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | | | | | | | | |
Collapse
|
3
|
Abstract
Hematospermia is a common harmless condition that invokes a lot of anxiety to the patient. Calculous obstruction of the ejaculatory duct is an unusual cause of hematospermia. We report one such case of hemospermia due to an ejaculatory duct calculus that was diagnosed with TRUS. An endoscopic approach should be attempted to manage all such cases.
Collapse
Affiliation(s)
- Iqbal Singh
- Department of Surgery, University College of Medical Sciences & GTB Hospital, Delhi-95, India.
| | | | | | | |
Collapse
|