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Published on: May 27, 2022
Haemospermia: a prospective study
1Surgical Division, Princess of Wales Royal Air Force Hospital, Ely.
Insights
Haemospermia, or blood in semen, often resolves spontaneously. Routine investigations, including cystoscopy for older men, can diagnose treatable causes, while younger men typically require non-invasive methods.
Area of Science:
- Urology
- Men's Health
Background:
- Haemospermia (blood in semen) is a concerning symptom for many men.
- While often benign, it can indicate underlying pathology requiring investigation.
Purpose of the Study:
- To evaluate the diagnostic yield of investigations for haemospermia in men of different age groups.
- To establish appropriate investigation pathways based on patient demographics and symptom characteristics.
Main Methods:
- A prospective study involving 74 men presenting with haemospermia.
- Categorization of patients by age (over 40 and under 40).
- Application of simple, non-invasive, and invasive investigations as clinically indicated.
Main Results:
- A diagnosis was achieved in all 9 men over 40 using simple investigations.
- In men under 40, 48% had no detectable pathology with initial assessment.
- A diagnosis was made in 32 of the remaining 34 younger men via simple investigations.
Conclusions:
- Routine investigations, including cystoscopy, are effective in identifying treatable causes of haemospermia in men over 40.
- Non-invasive investigations suffice for most younger men; invasive procedures are reserved for persistent or severe cases.
- Age and symptom severity are key factors in guiding the diagnostic approach for haemospermia.
Abstract:
A prospective study of 74 men with haemospermia is presented. Most (76%) had experienced 1 or 2 episodes only and 9 (12%) were over 40 years old. Simple investigations led to a diagnosis in all 9 of these men and of those under 40, no pathology could be detected in 48%. A diagnosis was made in 32 of the remaining 34 men by simple investigations. In patients over 40 years of age with haemospermia, a potentially treatable cause will normally be found by routine investigation which should include cystoscopy. In younger men, non-invasive investigation alone should identify any pathology. Invasive investigations should be reserved for those patients in whom the problem is prolonged, excessive or in association with other symptoms.
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