Aetiology, diagnosis and management of haemospermia: a review

To provide an overview of the aetiology, investigations and the various treatment methods currently available in the management of haemospermia.

Review of literature was effected through medline and index medicus search of major published indexed journals and books.

Published data on haemospermia, hemospermia, haematospermia and semen over the last five decades (1967-2007) were utilised.

Abstracts of selected articles were read and analysed to determine their possible contribution and relevance to this article.

All relevant articles were reviewed in full and contribution extracted for this review as necessary.

Haemospermia (haematospermia) is a relatively frequent, distressing and frightening symptom in sexually active men. It is usually a benign self-limiting condition resolving within several weeks except for the few with underlying aetiology including prostate malignancy and idiopathic. Patients presenting with haemospermia should have a detailed medical history, physical examillation including blood pressure measurement, genital and digital rectal examination. Persistent and recurrent haemospermia is best investigated by TRUS, CT, MRI, urethrocystoscopy, and biopsy and histological confirmation of malignancies. Specific treatment depends on the underlying pathological cause but often involves only minimal investigations and simple reassurance.