[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.