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At least 19 recordsLinked to original sources
PubMed2004

Association of hemospermia with prostate cancer.

PURPOSE: Hemospermia is uncommon clinical condition that usually follows a benign course. The association between hemospermia and prostate cancer has been reported but to our knowledge not thoroughly investigated. We studied the incidence of hemospermia and the association between prostate cancer and hemospermia in a large prostate cancer screening population. MATERIALS AND METHODS: Between 1991 and 2001, 26,126 ambulatory men 50 years or older (40 years or older with a family history of prostate cancer or black race) underwent a community based prostate cancer screening study using serum prostate specific antigen (PSA) and digital rectal examination (DRE). PSA measurement and DRE were repeated at 6-month or 1-year intervals depending on PSA for the remainder of the study. Men underwent prostate biopsy due to increased serum PSA (greater than 4.0 ng/ml until May 1995 or greater than 2.5 ng/ml after May 1995) or suspicious DRE. Men with a history of prostate cancer were excluded from study. Men completed a questionnaire, including information about hemospermia, at each screening visit. Hemospermia information from the initial questionnaire was analyzed. The relative risk of prostate cancer diagnosis in the overall prostate cancer screening population and the cohort with hemospermia was determined. Detailed prostate cancer characteristics were evaluated in those who had hemospermia and underwent radical prostatectomy. We used a multivariate logistic regression model to test the independent significance of hemospermia after adjusting for other known predictors of prostate cancer detection. RESULTS: Prostate cancer was detected in 1,708 of the 26,126 men (6.5%) who underwent prostate cancer screening. Prostate cancer was diagnosed in 19 of the 139 men (13.7%) who reported hemospermia upon entering the prostate cancer screening study. The median age of the 139 men was 61 years (range 40 to 89). Ten of the 13 men who underwent radical retropubic prostatectomy had stage pT2 disease, while 3 had stage pT3 disease. In the logistic regression model hemospermia was a significant predictor of prostate cancer diagnosis after adjusting for age, PSA and DRE results (OR 1.73, p = 0.054). CONCLUSIONS: Hemospermia is rare (0.5%) in a prostate cancer screening population. When a man presents with hemospermia, prostate cancer screening should be vigilantly performed since hemospermia is associated with an increased risk of prostate cancer.

Aged↗
PubMed2005

Characterization of localized seminal vesicle amyloidosis causing hemospermia: an analysis using immunohistochemistry and magnetic resonance imaging.

PURPOSE: We evaluated the characteristics of seminal vesicle amyloidosis (SVA) associated with hemospermia by immunohistochemistry and magnetic resonance imaging (MRI) as well as the clinical course of hemospermia. MATERIALS AND METHODS: Of 56 patients with hemospermia 12 underwent transperineal biopsy of the seminal vesicle under transrectal ultrasound monitoring. SVA was proved in 4 men 48 to 59 years old by histological and immunohistochemical examinations of specimens obtained by biopsy. Two men presented with the first episode of hemospermia and 2 presented with recurrent hemospermia. MRI at 1.5 Tesla was performed while hemospermia persisted and after its resolution. Patients were followed for 10 to 86 months with regard to the duration of hemospermia, the time of its resolution and its recurrence. RESULTS: Amyloid deposits in the subepithelial tissue of the seminal vesicles were permanganate sensitive, and positive for lactoferrin and the amyloid P component but negative for amyloid A protein, lambda and kappa chains, and beta2-microglobulin. The seminal vesicles with obvious intravesicular hemorrhage on needle puncture were hyperintense on T1-weighted images. After hemospermia resolution T1-weighted images became diffusely hypointense. T2-weighted images were of low intensity, representing amyloid deposits. Hemospermia resolved spontaneously in all patients in an average of 14 months. Although disease recurred in 1 patient after 8 months of resolution, it disappeared after 11 months of recurrence. CONCLUSIONS: Localized SVA with hemospermia shows hypointensity on T2-weighted MRI. Hemospermia is spontaneously resolved with the transition from hyperintense to hypointense T1-weighted MRI.

Amyloid↗
PubMed2005

[Hemospermia].

Hemospermia refers to the presence of blood in the seminal fluid and is not very common urologic symptom. Its prevalence remains unknown. Historically, hemospermia was linked to excessive sexual overindulgence, prolonged sexual abstinence, interrupted coitus. Newer imaging modalities have altered the diagnosis and etiological factors of hemospermia are now more frequently identified. Hemospermia can result from many causes. Infections or inflammatory disorders account from 39% to 55% of cases, malignancies and trauma account just 4-13%. The remaining 11% of cases were caused by a variety of other pathologic conditions. Predisposing diseases are prostatitis, epididymitis, urinary stones, tuberculosis, cirrhosis of the liver, arterial hypertension, hematologic diseases. In 30-70% of the cases there is no association with any significant pathology. Cases of primary and solitary hemospermia can be adequately assessed by urinanalysis, blood pressure measurement, genital and rectal examination, PSA-test, and reassurance of the patient. Persistent and recurrent cases of hemospermia are best clarified by transrectal ultrasound examination, cystoscopy, computer tomography and magnetic resonance imaging. Treatment depends on the diagnostic findings but often simply involves reassurance.

Adult↗
PubMed2005

A clinical entity of cystic dilatation of the utricle associated with hemospermia.

PURPOSE: We investigated the mechanism of hemospermia in patients with a midline cyst (MLC) of the prostate, focusing on cystic dilatation of the utricle (CDU) as a possible causative lesion. MATERIALS AND METHODS: Of 138 patients with hemospermia 30 (22%) had an MLC, of whom 19 underwent transperineal needle aspiration of the MLC and bilateral seminal vesicles to determine the site of bleeding. Following MLC aspiration a mixture of dye and contrast medium was injected. The verumontanum was observed endoscopically and pelvic x-ray was done. RESULTS: Seminal vesicle fluid on 1 or 2 sides was hemorrhagic in 13 of the 19 patients (aspiration failed in 6) and fluid from the MLC was nonhemorrhagic in 5 of the 19 (aspiration failed in 7). The MLC communicated with the urethra (CDU) in 15 patients (79%) and with 1 or 2 ejaculatory ducts in 11 (58%). In 5 of 11 patients with communication with the ejaculatory duct hemospermia persisted for more than 1 year. Four of these patients were cured by transurethral unroofing of the CDU. CONCLUSIONS: CDU is a significant underlying lesion for hemospermia. Communication with the ejaculatory ducts was frequent in patients with chronic hemospermia and transurethral unroofing was effective for eliminating hemospermia.

Adult↗
PubMed2002

[Hemospermia: diagnosis and therapeutic aspects. Seven case reports].

Hemospermia or hematospermia is a common benign condition, but its prevalence remains unknown and can result from several causes. The aetiology is idiopathic in about 30-70% of the cases. The hemospermia is first of inflammatory origin, in the young patients, where it is due to uretroprostatitis or orchi-epididymitis, but in the older, it is due to a benign of malignant prostatic tumors. Transrectal ultrasonography and magnetic resonance imaging can afforded the opportunity to best investigate the patients with hemospermia. Hemospermia is not an uncommon problem and in most instances has little clinical significance other than evoking much anxiety for the patient. In view of the literature, the authors discus the diagnostic and therapeutic approach of hemospermia through a series of seven cases.

Adolescent↗
PubMedDate not supplied

Urethral defects in geldings with hematuria and stallions with hemospermia.

A urethral defect, presumed to communicate with the corpus spongiosum penis, caused hematuria in seven geldings and hemospermia in three stallions. Hematuria in geldings occurred at the end of urination. Hematuria was not observed in stallions with hemospermia. A linear urethral defect was identified, by endoscopic examination, on the convex surface the urethra at the level of the ischial arch of each horse. Cause of the defect was not determined. Two stallions were successfully treated for hemospermia, one by temporary subischial urethrostomy combined with sexual rest for 10 weeks, and the other by sexual rest alone for 6 months. The third stallion had hemospermia 6 weeks after urethrostomy. The geldings were successfully treated for hematuria, six by temporary subischial urethrostomy, and one by a subischial incision that extended into the corpus spongiosum penis but did not enter the lumen of the urethra. Efficacy of subischial urethrostomy for treatment of hemospermia was difficult to assess because of the small number of surgically treated stallions. In geldings, surgery eliminated hematuria, presumably by reducing vascular pressure in the corpus spongiosum penis during urination, thus allowing the urethral defect to heal.

Animals↗
PubMed2000

Transrectal ultrasonographic findings in patients with hemospermia.

BACKGROUND: Hemospermia causes anxiety in many men. Its etiology includes inflammatory disorders, vascular lesions, malignancies and congenital anomalies. With the advent of modern transrectal ultrasonography (TRUS) and magnetic resonance imaging technology, we can now visualize the internal structures of the seminal vesicles and prostate, and identify a more accurate etiology for hemospermia. This study was performed to assess the efficacy of TRUS in the evaluation of hemospermia. METHODS: TRUS was used to evaluate 40 patients with hemospermia. Patients' ages ranged from 20 to 72 years, with an average age of 41 years. The duration of symptoms was 3 days to 10 years, (average age 12.4 months). Apart from three patients with hepatitis, there was no major illness found in the medical histories. TRUS was performed with a B & K, type 3535 transrectal transducer device, with an 1850 multiplane probe. RESULTS: TRUS revealed abnormalities in 33 (83%) of 40 patients, which included ejaculatory duct cysts, müllerian duct cysts, asymmetric seminal vesicle dilatation, preprostatic vein engorgement and prostatic enlargement. There were stones in the ejaculatory ducts, ejaculatory duct cysts, müllerian duct cysts or prostate. Nine patients with prostatic stones were under 40 years-of-age. Other than the development of stones, there were no significant differences between patients less than 40 years-of-age and those more than 40 years old. CONCLUSIONS: The results suggest that TRUS is an effective method for examining the seminal vesicles, ejaculatory duct and prostate complex. Sonoguided aspiration, injection of contrast medium or biopsy can further help to differentiate the nature of hemospermia.

Adult↗
PubMed1999

Endorectal coil MR imaging findings in hemospermia.

The purpose of this study was to illustrate the spectrum of abnormalities found at endorectal coil magnetic resonance (MR) imaging in patients with hemospermia. Ninety patients aged between 23 and 71 years (mean age 41 years) presenting with hemospermia underwent evaluation with endorectal coil MR imaging at 1.5 T. Duration of hemospermia ranged between 5 days and 4 years (mean 15 months). MR examination protocol included T1-weighted spin-echo (SE) and T2-weighted fast SE MR images obtained in the sagittal, coronal, and axial planes. Abnormalities were observed on endorectal-coil MR images in 49 of 90 patients (54%). Blood within the seminal vesicle or the ejaculatory duct was recognized in 23 of 90 patients (25%). Dilatation of the seminal vesicles or the ejaculatory duct was observed in 31 of 90 patients (34%). Cystic lesions were identified in 14 cases, eight of which involved the utriculus and six the ejaculatory duct. Calculi within the seminal vesicles were depicted in seven patients. No malignant disease was demonstrated. In conclusion, despite the evidence that hemospermia is most often a benign and self-limiting condition, we found that endorectal coil MR imaging can detect abnormal findings in more than half of the patients, and may be helpful in assessing the level at which hemorrhage occurred and in defining the cause of the disease.

Adult↗
PubMed2001

Hemospermia: review of the management with 5 years follow-up.

OBJECTIVE: To review our experience with hemospermia and a long term follow-up. MATERIAL AND METHOD: Medical records of patients with hemospermia treated at the Division of Urology, Ramathibodi Hospital between 1993 and 1995 were reviewed. Clinical presentation, investigation, diagnosis, treatment, outcomes and long term follow-up were noted. RESULTS: Sixty-eight patients were found and completed follow-up to 5 years. The mean age was 40 years (range 28-62). Physical examination including DRE and urine examinations were done in all of the cases. Special investigations such as PSA, TRUS, IVP and cystourethroscopy were performed in selected cases. Prostatitis was found in 27.9 per cent, tuberculosis in 4.4 per cent, sexually related causes in 5.8 per cent and idiopathic in 61 per cent No malignancy was found in this study. Hypertension was found in 7.3 per cent of the patients. Thirty-two per cent had recurrent episodes of hemospermia. Specific treatment was used only for prostatitis and tuberculosis. No specific treatment was used for the idiopathic group. CONCLUSIONS: Hemospermia is a benign condition. Most of the causes were from idiopathic and inflammation. Only simple investigation was needed and treatment was recommended depending on the diagnosis and no specific treatment was needed for idiopathic cause.

Adult↗
PubMedDate not supplied

[Hemospermia: cause, clinical significance and our experience].

The hemospermia is first of inflammatory origin, in the young, where it is due to urethro-prostatitis or orchio-epididymitis, in the old, to benign or malignant prostatic tumours. In 30-70% of the cases it is idiopathic. It can be connected with a prolonged sexual abstinence or with intense sexual activity. Predisposing diseases are prostatitis, epididymitis, urinary stones, gonorrhea, syphilis, tuberculosis, cirrhosis of the liver, blood hypertension, haematologic diseases. Our casistics, 60 patients in 4 years (1987-1990), has showed the hemospermia as isolated episode in 20% of the cases, in 35% associated with urologic symptoms. Juvenile forms, connected with urethro-prostatitis, are often associated with the echographic presence of periurethral calcifications or to a swelling of the seminal vesicles. In 8 patients, the hemospermia was recurrent, and due to a prostatic tumour. In 2 patients, with recurrent hemospermia, a urogenital tuberculosis has been detected.

Adult↗
PubMed1996

[Transrectal prostatic echography in the study of hemospermia. An assessment of an 85-patient case load].

Eighty-five patients with hemospermia were examined with blood tests, sperm culture, transrectal US (TRUS) and cystourethroscopy. Blood tests and sperm culture demonstrated bacterial inflammation in 48 patients (56.47%). At cystourethroscopy, the urethra was normal or hyperemic in all patients. TRUS demonstrated 40 cases (47.05%) of periurethral calcifications and also with calcifications in the two glandular lobes. TRUS also demonstrated prostatic inflammation in progress or its outcome in 21 patients (24.70%), ectasia and seminal vesicle inflammation in 10 patients (11.76%), a prostatic tumor in 3 patients (3.52%). No patient had cysts, stones or cancers in the seminal vesicles. In 11 patients (12.94%), no specific cause of hemospermia was detected, even though 4 of these patients (4.70%) had received anticoagulants for former heart ischemia. Benign prostatic hypertrophy was found in 44 patients (51.76%) but we did not consider it a possible cause of hemospermia because of the high frequency of this condition in the male population. To conclude, TRUS could demonstrate the cause of hemospermia in most of our patients, which makes us suggest it as the diagnostic technique of choice in the patients with ejaculatory conditions, after clinical exams and laboratory tests, because it allows to study the prostate, the seminal vesicles and the urethra.

Adolescent↗
PubMed1997

Magnetic resonance imaging in hemospermia.

PURPOSE: We evaluated the prostate and seminal tract with magnetic resonance imaging (MRI) in patients with hemospermia. MATERIALS AND METHODS: To evaluate the prostate and seminal tract in 17 patients 20 to 59 years old (mean age 44) with hemospermia we performed transrectal ultrasound and MRI using an endorectal surface coil with a 1.5 tesla unit. Mean duration of hemospermia was 32 months (1 week to 16 years). RESULTS: Abnormalities were noted on transrectal ultrasound in 15 of the 17 patients (88%) and on MRI in all. Of the 12 cases of hemorrhage 10 involved the seminal vesicle and 2 involved the ejaculatory duct. There were 12 cystic lesions, including 7 in the müllerian and 5 in the ejaculatory ducts. Of 19 cases calculi were detected in the prostate in 5, seminal vesicle in 8, and ejaculatory and müllerian duct cysts in 4 and 2, respectively. There was 1 case of prostatic atrophy and 1 wolffian duct anomaly associated with an ejaculatory duct cyst, ectopic ureterocele and absence of the left kidney. CONCLUSIONS: MRI with an endorectal surface coil is a powerful modality for evaluating the seminal tracts of patients with hemospermia. It can be performed clinically when transrectal ultrasonography is not satisfactory.

Adult↗
PubMed1996

[Hemospermia: role of transrectal echography].

Hemospermia is a common benign condition, but is prevalence remains unknown, and can result from several causes. The etiology is idiopathic in about 50% of cases. The advent of transrectal ultrasonography has afforded the opportunity to best evaluate patients with hemospermia. Eighty patients affected by hemospermia were studied with Stamey test, semen analysis and culture, and transrectal ultrasonography (TRUS). Infection was detected in 16/80 of the cases (20%), while in 11/80 patients (14%) was present only excessive white blood cells in expressed prostatic secretions. TRUS showed abnormalities in 70/80 of patients (88%), including periurethral and ejaculatory calculi (42/70 pt., 60%), dilated seminal vesicles (22/70 pt., 31.4%) and müllerian duct cyst (6/70 pt., 8.6%). Stamey test and TRUS are the more usefulness investigations in hemospermia, since they can demonstrate the pathologic causes in about 90% of the cases.

Adult↗
PubMed2005

[Hemospermia and Mullerian duct cyst].

OBJECTIVES: To report one case of utriculum cyst treated endoscopically. METHODS: We describe the case of a mid-age male patient consulting for long-term monosymptomatic hemospermia. Rectal digital examination revealed a non suspicious adenomatous prostate. Transrectal ultrasound showed a complicated utriculum cyst. RESULTS: Endoscopical marsupialization of the cyst was performed with complete remission of hemospermia. CONCLUSIONS: Transrectal ultrasound should be performed in all patients presenting with long-term hemospermia. Endoscopical marsupialization of the mullerion duct cyst is indicated in symptomatic patients or those with complex cysts on ultrasound, offering a high cure/improvement rate in this group of patients without secondary effects.

Cysts↗
PubMed2006

[Massage of transrectal heat rotating magnetic field in the treatment of obstinate hemospermia].

OBJECTIVE: To investigate the effect of transrectal heat rotating magnetic field in the treatment of obstinate hemospermia. METHODS: Sixty-eight cases of obstinate hemospermia were selected and treated by routine ways and massage by transrectal heat rotating magnetic field. The device of transrectal heat rotating magnetic field was used, 45 min/section/day, 10 sections as one sequence. The morphology of prostate and seminal vesicle by ultrasonic and red blood cells in sperm were observed and compared before and after the treatment, and then all the cases were followed. RESULTS: After one to four sequences, among 64 cases, which were caused by prostatitis and spermatocystitis, the cure rate was 81.25% (52 cases) and availability rate was 18.75% (12 cases). Sixty-two cases were followed for one to ten years, in which 6 cases intercurrently relapsed because of drinking, fatigue and frequent sexual intercourse, and then the symptom was controlled after restarting the treatment. Among 68 cases, 4 cases were verumontanum polyps and the symptom was disappeared after electrocautery. CONCLUSION: Routine treatment with massage by transrectal heat rotating magnetic field have remarkable therapeutic effects on obstinate hemospermia.

Adolescent↗
PubMed1975

Hemospermia.

A study of 26 patients with primary hemospermia has been made. When primary hemospermia was the only symptom, urologic investigation was normal. It appears that such patients do not require detailed investigation whereas those presenting with hemospermia and other urologic symptoms require further investigations appropriate to those symptoms.

Adolescent↗
PubMed1982

Massive hemospermia: a new etiology and simplified treatment.

Hemospermia is a common urologic symptom that is usually benign and self-limited, and required no clinical investigation. Massive hemospermia causing hematuria, with clot formation and occasional urinary retention, occurs in a subset of patients. Three patients are reported in whom cystourethroscopy demonstrated nonvaricose abnormal posterior urethral vessels. Treatment consisted of fulguration of the vessels. One patient was cured, 1 had no symptoms for 3 years and 1 improved slightly. Endoscopically, this is a safe simple outpatient surgical procedure that is recommended for massive hemospermia due to abnormal posterior urethral vessels.

Adult↗
PubMed1994

Transrectal ultrasonography of the prostate and seminal vesicles with hemospermia.

Transrectal ultrasonography was performed in 46 patients with hemospermia. Abnormal findings in the prostate and seminal vesicles, including prostatic stones, benign prostatic hyperplasia, prostatitis, and dilatation and calculi of the seminal vesicles, were observed in 34 patients (73.9%). However, no malignant lesions were found in the prostate or seminal vesicles. Transrectal ultrasonography was a useful and noninvasive procedure to investigate the causes of hemospermia. Furthermore, transrectal ultrasonography could demonstrate latent diseases and exclude malignancy of the prostate and seminal vesicle in patients with hemospermia.

Blood↗