Iqbal Singh1, Naveen Sharma, Nain Singh
1Department of Surgery, University College of Medical Sciences & GTB Hospital, Delhi-95, India. iqbal@bol.net.in
Hematospermia is often harmless but can cause patient anxiety. This case report describes a rare cause of hematospermia: a calculus in the ejaculatory duct. The patient was diagnosed using transrectal ultrasound (TRUS), which identified the obstruction. Endoscopic removal of the calculus was performed, and the patient's symptoms resolved. The authors suggest that structural causes like ejaculatory duct calculi should be considered in persistent cases of hematospermia. This case highlights the diagnostic and therapeutic potential of TRUS and endoscopic techniques.
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Area of Science:
Background:
Hematospermia is frequently observed in clinical practice and is often benign. Many patients experience significant psychological distress due to the condition. While most cases are idiopathic or linked to infections, structural causes remain underexplored. Prior research has shown that hematospermia is typically managed conservatively. However, structural abnormalities like ejaculatory duct obstruction are rarely considered. No prior work had resolved the role of ejaculatory duct calculi in hematospermia. This gap motivated a closer examination of noninfectious causes. TRUS has been established as a diagnostic tool in urology. Yet, the specific contribution of calculi to hematospermia remains unclear.
Purpose Of The Study:
This case aimed to identify a structural cause of hematospermia beyond typical etiologies. The patient presented with persistent hematospermia and no signs of infection. The goal was to determine whether ejaculatory duct obstruction could be a contributing factor. The study sought to demonstrate the diagnostic potential of TRUS in such cases. It also aimed to evaluate endoscopic intervention as a management strategy. The focus was on a rare but treatable cause of hematospermia. The motivation stemmed from the need to expand diagnostic approaches. This case highlights the importance of considering anatomical causes in persistent cases.
The case discusses ejaculatory duct calculus as a rare cause of hematospermia.
Transrectal ultrasound (TRUS) was used to detect the ejaculatory duct calculus.
Endoscopic removal is proposed because it allows direct access to the obstructing calculus.
The patient's hematospermia resolved after endoscopic calculus removal.
Yes, the calculus was confirmed histologically following endoscopic removal.
Main Methods:
The patient underwent a transrectal ultrasound to visualize the ejaculatory ducts. TRUS was used to detect the presence of a calculus in the ejaculatory duct. No prior imaging had been performed to rule out structural causes. The diagnostic approach was guided by clinical suspicion of obstruction. Endoscopic techniques were considered for calculus removal. The study relied on imaging and clinical correlation. No experimental models were used in this case report. The findings were based on direct visualization and clinical outcomes.
Main Results:
TRUS identified a calculus obstructing the ejaculatory duct in the patient. No infectious etiology was found to explain the hematospermia. The calculus was localized to the distal portion of the duct. Endoscopic removal was proposed as a treatment option. The patient's symptoms resolved following the procedure. No complications were reported from the endoscopic intervention. The calculus was confirmed histologically after removal. These findings suggest that calculi may be a treatable cause of hematospermia.
Conclusions:
The authors propose that ejaculatory duct calculi may be an underdiagnosed cause of hematospermia. TRUS is a valuable diagnostic tool for identifying such obstructions. Endoscopic removal is suggested as a management strategy for this condition. The case supports the need for imaging in persistent hematospermia cases. No prior work had resolved the effectiveness of endoscopic approaches in this context. The authors suggest that structural causes should be considered in diagnostic evaluations. This case provides evidence for a treatable cause of hematospermia. The findings may guide future diagnostic and therapeutic strategies.
The authors suggest endoscopic removal as a management option for ejaculatory duct calculi.