Hematospermia: diagnosis and treatment

Area of Science:

• Urology
• Andrology

Background:

• Blood in ejaculate, or hematospermia, is an uncommon urologic symptom, accounting for 1% of presentations.
• While often benign and self-limiting, hematospermia can indicate underlying bladder-prostate or systemic malignancy.

Purpose of the Study:

• To outline diagnostic and treatment strategies for hematospermia.
• To differentiate between idiopathic and secondary hematospermia requiring etiological treatment.

Main Methods:

• Comprehensive patient history and physical examination.
• Laboratory tests, transrectal ultrasound (TRUS) of the prostate, MRI, CT scans, and cystoscopy.
• Assessment of patient age, hematospermia duration/recurrence, and presence of hematuria.

Main Results:

• Hematospermia is rarely linked to significant pathology, particularly in younger individuals.
• Diagnostic approach and treatment extent are guided by patient age, symptom chronicity, and associated hematuria.
• Secondary hematospermia necessitates identification and treatment of the underlying cause.

Conclusions:

• Rational, evidence-based decision-making is crucial for managing hematospermia.
• Understanding pathophysiology and age-specific prevalence aids in minimizing complications.
• TRUS, cystoscopy, and basic labs are key for definitive diagnosis when indicated.